GENIE Acquisition R3.1 Conformance Statement for DICOM v3.0

Technical Publications Direction 2358711-100 Revision 0 GENIE Acquisition R3.1 Conformance Statement for DICOM v3.0 This document applies to the following systems: Millennium MPR/MPS, MG and MC Optima NX AC400 Magicam MyoSight Copyright 2002 by General Electric Company

GE Medical Systems GE Medical Systems: Telex 3797371 P.O. Box 414, Milwaukee, Wisconsin, 53201 U.S.A. (Asia, Pacific, Latin America, North America) GE Medical Systems -- Europe: Telex 698626 283 rue de la Miniére, B.P.34, 78533, Buc Cedex, France

Revision History Date Name Description Of Change Revision 26 September 2002 Allen J.Velani Creation 0.0 i

TABLE OF CONTENTS 1. INTRODUCTION... 1 1 1.1 OVERVIEW... 1 1 1.2 OVERALL DOCUMENT STRUCTURE... 1 1 1.3 INTENDED AUDIENCE... 1 3 1.4 SCOPE AND FIELD OF APPLICATION... 1 3 1.5 IMPORTANT REMARKS... 1 4 1.6 REFERENCES... 1 4 1.7 DEFINITIONS... 1 5 1.8 SYMBOLS AND ABBREVIATIONS... 1 5 2. NETWORK CONFORMANCE STATEMENT... 2 1 2.1 INTRODUCTION... 2 1 2.2 IMPLEMENTATION MODEL... 2 2 2.3 AE SPECIFICATIONS... 2 3 2.4 COMMUNICATION PROFILES... 2 16 2.5 EXTENSIONS / SPECIALIZATIONS / PRIVATIZATIONS... 2 16 2.6 CONFIGURATION... 2 17 2.7 SUPPORT OF EXTENDED CHARACTER SETS... 2 18 3. NUCLEAR MEDICINE (NM) INFORMATION OBJECT IMPLEMENTATION... 3 1 3.1 introduction... 3 1 3.2 NM IOD Implementation... 3 1 3.3 NM Entity-Relationship Model... 3 1 3.4 IOD MODULE TABLE... 3 3 3.5 INFORMATION MODULE DEFINITIONS... 3 4 3.6 PRIvate data dictionary... 3 24 4. PATIENT ROOT QUERY/RETRIEVE INFORMATION MODEL DEFINITION... 4-1 4.1 introduction...4-1 4.2 Patient Root Information Model Description...4-1 ii

4.3 Patient Root Information Model Entity-Relationship Model...4-1 4.4 INFORMATION Model Keys...4-3 4.5 PRIvate data dictionary...4-5 5. STUDY ROOT QUERY/RETRIEVE INFORMATION MODEL DEFINITION... 5 1 5.1 introduction... 5 1 5.2 Study Root Information Model Description... 5 1 5.3 Study Root Information Model Entity-Relationship Model... 5 1 5.4 INFORMATION Model Keys... 5 3 5.5 PRIvate data dictionary... 5 5 6. MODALITY WORKLIST INFORMATION MODEL DEFINITION... 6-1 6.1 INTRODUCTION...6-1 6.2 MODALITY WORKLIST INFORMATION MODEL DESCRIPTION...6-1 6.3 MODALITY WORKLIST INFORMATION MODEL ENTITY-RELATIONSHIP MODEL...6-1 6.4 INFORMATION MODEL MODULE TABLE...6-4 6.5 INFORMATION MODEL KEYS...6-5 6.6 PRIVATE DATA DICTIONARY...6-11 iii

LIST OF TABLES TABLE 3.3-1 MAPPING OF DICOM ENTITIES TO GENIE ACQUISITION ENTITIES... 3 3 TABLE 3.4-1 NM IMAGE IOD MODULES... 3 4 TABLE 3.5-1 PATIENT MODULE ATTRIBUTES... 3 5 TABLE 3.5-2 GENIE ACQUISITION PATIENT MODULE ATTRIBUTES... 3 5 TABLE 3.5-3 GENERAL STUDY MODULE ATTRIBUTES... 3 6 TABLE 3.5-4 PATIENTS STUDY MODULE ATTRIBUTES... 3 6 TABLE 3.5-5 GENIE ACQUISITION STUDY MODULE ATTRIBUTES... 3 7 TABLE 3.5-6 GENERAL SERIES MODULE ATTRIBUTES... 3 7 TABLE 3.5-7 GENIE ACQUISITION SERIES MODULE ATTRIBUTES... 3 8 TABLE 3.5-8 FRAME OF REFERENCE MODULE ATTRIBUTES... 3 9 TABLE 3.5-9 GENERAL EQUIPMENT MODULE ATTRIBUTES... 3 10 TABLE 3.5-10 GENERAL IMAGE MODULE ATTRIBUTES... 3 10 TABLE 3.5-11 GENIE ACQUISITION IMAGE MODULE ATTRIBUTES... 3 11 TABLE 3.5-12 IMAGE PIXEL MODULE ATTRIBUTES... 3 12 TABLE 3.5-13 GENIE ACQUISITION IMAGE PIXEL MODULE ATTRIBUTES... 3 13 TABLE 3.5-14 MULTI-FRAME MODULE ATTRIBUTES... 3 13 TABLE 3.5-15 SOP COMMON MODULE ATTRIBUTES... 3 14 TABLE 3.5-16 NM/PET PATIENT ORIENTATION MODULE ATTRIBUTES... 3 14 TABLE 3.5-17 NM IMAGE PIXEL MODULE ATTRIBUTES... 3 15 TABLE 3.5-18 NM MULTI-FRAME MODULE ATTRIBUTES... 3 15 TABLE 3.5-19 ENUMERATED VALUES FOR FRAME INCREMENT POINTER... 3 16 TABLE 3.5-20 NM IMAGE MODULE ATTRIBUTES... 3 16 TABLE 3.5-21 NM ISOTOPE MODULE ATTRIBUTES... 3 18 TABLE 3.5-22 GENIE ACQUISITION ISOTOPE MODULE ATTRIBUTES... 3 20 TABLE 3.5-23 NM DETECTOR MODULE ATTRIBUTES... 3 20 TABLE 3.5-24 GENIE ACQUISITION DETECTOR MODULE ATTRIBUTES... 3 21 TABLE 3.5-25 NM TOMO ACQUISITION MODULE ATTRIBUTES... 3 22 TABLE 3.5-26 GENIE ACQUISITION TOMO ACQUISITION MODULE ATTRIBUTES... 3 22 TABLE 3.5-27 NM MULTI-GATED ACQUISITION MODULE ATTRIBUTES... 3 22 TABLE 3.5-28 GENIE ACQUISITION MULTI-GATED ACQUISITION MODULE ATTRIBUTES... 3 23 TABLE 3.5-29 NM PHASE MODULE ATTRIBUTES... 3 23 TABLE 3.6-1 PRIVATE CREATOR IDENTIFICATION (GEMS_GENIE_1)... 3 24 iv

TABLE 4.3-1 MAPPING OF DICOM ENTITIES TO GENIE ACQUISITION ENTITIES...4-3 TABLE 4.4-1 PATIENT LEVEL ATTRIBUTES FOR THE PATIENT ROOT QUERY/RETRIEVE INFORMATION MODEL...4-4 TABLE 4.4-2 Q/R PATIENT LEVEL AND LOCATION FOR RETRIEVE ATTRIBUTES...4-4 TABLE 4.4-3 STUDY LEVEL ATTRIBUTES FOR THE PATIENT ROOT QUERY/RETRIEVE INFORMATION MODEL...4-4 TABLE 4.4-4 Q/R STUDY LEVEL AND LOCATION FOR RETRIEVE ATTRIBUTES...4-4 TABLE 4.4-5 SERIES LEVEL ATTRIBUTES FOR THE PATIENT ROOT QUERY/RETRIEVE INFORMATION MODEL...4-5 TABLE 4.4-6 Q/R SERIES LEVEL AND LOCATION FOR RETRIEVE ATTRIBUTES...4-5 TABLE 4.4-7 IMAGE LEVEL ATTRIBUTES FOR THE PATIENT ROOT QUERY/RETRIEVE INFORMATION MODEL...4-5 TABLE 4.4-8 Q/R IMAGE LEVEL AND LOCATION FOR RETRIEVE ATTRIBUTES...4-5 TABLE 5.3-1 MAPPING OF DICOM ENTITIES TO GENIE ACQUISITION ENTITIES... 5 3 TABLE 5.4-1 STUDY LEVEL ATTRIBUTES FOR THE STUDY ROOT QUERY/RETRIEVE INFORMATION MODEL... 5 3 TABLE 5.4-2 Q/R STUDY LEVEL AND LOCATION FOR RETRIEVE ATTRIBUTES... 5 4 TABLE 5.4-3 SERIES LEVEL ATTRIBUTES FOR THE STUDY ROOT QUERY/RETRIEVE INFORMATION MODEL... 5 4 TABLE 5.4-4 Q/R SERIES LEVEL AND LOCATION FOR RETRIEVE ATTRIBUTES... 5 4 TABLE 5.4-5 IMAGE LEVEL ATTRIBUTES FOR THE STUDY ROOT QUERY/RETRIEVE INFORMATION MODEL... 5 4 TABLE 5.4-6 Q/R IMAGE LEVEL AND LOCATION FOR RETRIEVE ATTRIBUTES... 5 4 TABLE 6.3-1 MAPPING OF DICOM ENTITIES TO GENIE ACQUISITION ENTITIES...6-4 TABLE 6.4-1 MODALITY WORKLIST INFORMATION MODEL MODULES...6-4 TABLE 6.5-1 SOP COMMON MODULE ATTRIBUTES...6-6 TABLE 6.5-2 SCHEDULED PROCEDURE STEP MODULE ATTRIBUTES...6-6 TABLE 6.5-3 REQUESTED PROCEDURE MODULE ATTRIBUTES...6-7 TABLE 6.5-4 IMAGING SERVICE REQUEST MODULE ATTRIBUTES...6-8 TABLE 6.5-5 VISIT IDENTIFICATION MODULE ATTRIBUTES...6-8 TABLE 6.5-6 VISIT STATUS MODULE ATTRIBUTES...6-9 TABLE 6.5-7 VISIT RELATIONSHIP MODULE ATTRIBUTES...6-9 TABLE 6.5-8 VISIT ADMISSION MODULE ATTRIBUTES...6-9 TABLE 6.5-9 PATIENT RELATIONSHIP MODULE ATTRIBUTES...6-9 TABLE 6.5-10 PATIENT IDENTIFICATION MODULE ATTRIBUTES...6-10 TABLE 6.5-11 PATIENT DEMOGRAPHIC MODULE ATTRIBUTES...6-10 TABLE 6.5-12 PATIENT MEDICAL MODULE ATTRIBUTES...6-11 v

1. INTRODUCTION 1.1 OVERVIEW This DICOM Conformance Statement is divided into Sections as described below: Section 1 (Introduction), which describes the overall structure, intent, and references for this Conformance Statement Section 2 (Network Conformance Statement), which specifies the GEMS equipment compliance to the DICOM requirements for the implementation of Networking features. Section 3 (Nuclear Medicine Information Object Implementation), which specifies the GEMS equipment compliance to DICOM requirements for the implementation of a Nuclear Medicine Information Object. Section 4 (Patient Root Query/Retrieve Information Model Definition), which specifies the GEMS equipment compliance to DICOM requirements for the implementation of support for remote query/retrieve by patient of a Nuclear Medicine Information Object. Section 5 (Study Root Query/Retrieve Information Model Definition), which specifies the GEMS equipment compliance to DICOM requirements for the implementation of support for remote query/retrieve by study of a Nuclear Medicine Information Object. Section 6 (Modality Worklist Information Model Definition), which specifies the GEMS equipment compliance to DICOM requirements for the implementation of support for retrieving a worklist. 1.2 OVERALL DOCUMENT STRUCTURE The Documentation Structure of the GEMS Conformance Statements and their relationship with the DICOM v3.0 Conformance Statements is shown in the Illustration below. 1 1

ID/Net v3.0 Introduction to the Integrated DICOM/Network v3.0 (ID/Net v3.0) Conformance Statement Direction: 2118780 APPLICATION ENTITY SPECIFICATION (SERVICE CLASSES, INFORMATION OBJECTS, MESSAGE EXCHANGES, ETC.) Product Implementation: CT Advantage Conformance MR Advantage Statement Conformance Direction: GENIE Acquisition Statement Conformance Direction: Statement Direction: 2358711-100... Conformance Statement Direction:... DICOM STANDARD Standard Specification: DICOM V 3.0 DICOM V 3.0 Part 1 DICOM V 3.0 Part 2 DICOM V 3.0 Part 3 Part 4 DICOM V 3.0 Part 16 This document specifies the DICOM v3.0 implementation. It is entitled: GENIE Acquisition R3.1 Conformance Statement for DICOM v3.0 Direction 2358711-100 This DICOM Conformance Statement documents the DICOM v3.0 Conformance Statement and Technical Specification required to interoperate with the GEMS network interface. Introductory information, which is applicable to all GEMS Conformance Statements, is described in the document: 1 2

Introduction to the Integrated DICOM/Network v3.0 (ID/Net v3.0) Conformance Statement Direction: 2118780. This Introduction familiarizes the reader with DICOM terminology and general concepts. It should be read prior to reading the individual products GEMS Conformance Statements. The GEMS Conformance Statement, contained in this document, also specifies the Lower Layer communications which it supports (e.g., TCP/IP). However, the Technical Specifications are defined in the DICOM v3.0 Part 8 standard. For more information including Network Architecture and basic DICOM concepts, please refer to the Introduction. For more information regarding DICOM, copies of the Standard may be obtained on the Internet at http://medical.nema.org. Comments on the standard may be addressed to: DICOM Secretariat NEMA 1300N. 17 th Street, Suite 1847 Rosslyn, VA 22209 USA Phone: +1.703.841.3200 1.3 INTENDED AUDIENCE The reader of this document is concerned with software design and/or system integration issues. It is assumed that the reader of this document is familiar with the DICOM v3.0 Standards and with the terminology and concepts which are used in those Standards. If readers are unfamiliar with DICOM v3.0 terminology they should first refer to the document listed below, then read the DICOM v3.0 Standard itself, prior to reading this DICOM Conformance Statement document. Introduction to the Integrated DICOM/Network v3.0 (ID/Net v3.0) Conformance Statement Direction: 2118780 1.4 SCOPE AND FIELD OF APPLICATION It is the intent of this document, in conjunction with the Introduction to the Integrated DICOM/Network v3.0 (ID/Net v3.0) Conformance Statement, Direction: 2118780, to provide an unambiguous specification for GEMS implementations. This specification, called a Conformance Statement, includes a DICOM v3.0 Conformance Statement and is necessary to ensure proper processing and interpretation of GEMS medical data exchanged using DICOM v3.0. The GEMS Conformance Statements are available to the public. The reader of this DICOM Conformance Statement should be aware that different GEMS devices are capable of using different Information Object Definitions. For example, a GEMS CT Scanner may send images using the CT Information Object, MR Information Object, Secondary Capture Object, etc. Included in this DICOM Conformance Statement are the Module Definitions which define all data elements used by this GEMS implementation. If the user encounters 1 3

unspecified private data elements while parsing a GEMS Data Set, the user is well advised to ignore those data elements (per the DICOM v3.0 standard). Unspecified private data element information is subject to change without notice. If, however, the device is acting as a "full fidelity storage device", it should retain and re-transmit all of the private data elements which are sent by GEMS devices. 1.5 IMPORTANT REMARKS The use of these DICOM Conformance Statements, in conjunction with the DICOM v3.0 Standards, is intended to facilitate communication with GE imaging equipment. However, by itself, it is not sufficient to ensure that inter-operation will be successful. The user (or user s agent) needs to proceed with caution and address at least four issues: Integration - The integration of any device into an overall system of interconnected devices goes beyond the scope of standards (DICOM v3.0), and of this introduction and associated DICOM Conformance Statements when interoperability with non-ge equipment is desired. The responsibility to analyze the applications requirements and to design a solution that integrates GE imaging equipment with non GE systems is the user s responsibility and should not be underestimated. The user is strongly advised to ensure that such an integration analysis is correctly performed. Validation - Testing the complete range of possible interactions between any GE device and non GE devices, before the connection is declared operational, should not be overlooked. Therefore, the user should ensure that any non GE provider accepts full responsibility for all validation required for their connection with GE devices. This includes the accuracy of the image data once it has crossed the interface between the GE imaging equipment and the non GE device and the stability of the image data for the intended applications. Such a validation is required before any clinical use (diagnosis and/or treatment) is performed. It applies when images acquired on GE imaging equipment are processed/displayed on a non-ge device, as well as when images acquired on non-ge equipment is processed/displayed on a GE console or workstation. Future Evolution - GE understands that the DICOM Standard will evolve to meet the user's growing requirements. GE is actively involved in the development of the DICOM v3.0 Standard. DICOM v3.0 will incorporate new features and technologies and GE may follow the evolution of the Standard. The GEMS protocol is based on DICOM v3.0 as specified in each ID/Net DICOM Conformance Statement. Evolution of the Standard may require changes to devices which have implemented DICOM v3.0. In addition, GE reserves the right to discontinue or make changes to the support of communications features (on its products) reflected on by these ID/Net DICOM Conformance Statements. The user should ensure that any non GE provider, which connects with GE devices, also plans for the future evolution of the DICOM Standard. Failure to do so will likely result in the loss of function and/or connectivity as the DICOM Standard changes and GE Products are enhanced to support these changes. Interaction - It is the sole responsibility of the non GE provider to ensure that communication with the interfaced equipment does not cause degradation of GE imaging equipment performance and/or function. 1.6 REFERENCES A list of references which is applicable to all GEMS Conformance Statements is included in the Introduction to the Integrated DICOM/Network v3.0 (ID/Net v3.0) Conformance Statement, Direction: 2118780. 1 4

The information object implementation refers to DICOM PS 3.3 (Information Object Definition). 1.7 DEFINITIONS A set of definitions which is applicable to all GEMS Conformance Statements is included in the Introduction to the Integrated DICOM/Network v3.0 (ID/Net v3.0) Conformance Statement, Direction: 2118780. 1.8 SYMBOLS AND ABBREVIATIONS A list of symbols and abbreviations which is applicable to all GEMS Conformance Statements is included in the Introduction to the Integrated DICOM/Network v3.0 (ID/Net v3.0) Conformance Statement, Direction: 2118780. 1 5

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2. NETWORK CONFORMANCE STATEMENT 2.1 INTRODUCTION This section of the DICOM Conformance Statement specifies the compliance to DICOM conformance requirements for the relevant Networking features on this GEMS product. Note that the format of this section strictly follows the format defined in DICOM Standard PS 3.2 (Conformance). Please refer to that part of the standard while reading this section. The GENIE Acquisition DICOM implementation allows the user to send Nuclear Medicine image data, acquired on GENIE Acquisition, to another DICOM station. For example, the user may wish to send data to a GENIE Processing and Review station in order to run the CEqual processing protocol. In this situation GENIE Acquisition is providing the DICOM C-STORE service as a service class user (SCU). GENIE Acquisition also allows query and retrieve of data stored in its local database from a remote station. In this situation GENIE Acquisition is providing the DICOM C-FIND and C-MOVE services as a service class provider (SCP). The GENIE Acquisition DICOM implementation also provides a verification mechanism by which a remote application entity (AE) can verify application-level communication with the GENIE Acquisition DICOM Server. Also provided is a mechanism by which a GENIE Acquisition user can verify application-level communication with a remote DICOM AE. In these situations, GENIE Acquisition provides the DICOM C-ECHO service as both a SCP and SCU, respectively. The GENIE Acquisition DICOM implementation can be configured to send Image data in a variety of formats. These formats allow the GENIE Acq to send data to an Xpert P&R, GENIE P&R, POWERstation as well as an entegra For example, the Xpert P&R expects multigated tomo data as an image per energy set per detector whereas the GENIE P&R expects an image per bin per energy set per detector. GENIE Acquisition can be configured to correct image data as part of the DICOM transfer. GENIE Acquisition supports DICOM Modality Worklist as a service class user (SCU). The GENIE Acquisition worklist feature enables an operator to get their schedule of scans to perform directly from a Hospital/Radiology Information System (HIS/RIS). As well as providing a schedule of scans, the HIS/RIS also provides patient and study data. This reduces the operators need for re-entering information already entered at the HIS/RIS. 2 1

2.2 IMPLEMENTATION MODEL All DICOM functionality on the GENIE Acquisition product is logically provided by the DICOM Server AE. The DICOM Server AE is commanded to perform DICOM services through the use of the GENIE Acquisition user interface. The DICOM Server AE also listens on a pre-defined port for incoming connections from remote DICOM AEs. 2.2.1 Application Data Flow Diagram The Basic and Specific Application models for this device are shown in the following illustration : Modality Worklist SCU Image Send SCU Image Retrieve SCP DICOM Server AE Remote Modality Worklist SCP Remote Storage SCP Remote Retrieve SCU Query SCP Verify SCP Remote Query SCU Remote Verify SCP Verify SCU DICOM Standard Interface Remote Verify SCU 2 2

2.2.2 Functional Definition of AE s The GENIE Acquisition DICOM Server AE initiates the following functions: Worklist: Initiates a DICOM association in order to retrieve a list of scans to perform from the remote AE. Issues a C-FIND-RQ for DICOM Scheduled Procedure Steps and waits for C-FIND-RSP messages. The first C-FIND-RSP contains a match and a status of pending. All other matches are also returned in C-FIND-RSP messages with status pending until the last message which is returned with a final status of success, warning or failure. Store: Initiates a DICOM association in order to send images to a remote AE. If the remote AE accepts a presentation context applicable to the image(s) being sent, the DICOM Server will send the images via the C-STORE service. Verify: Initiates a DICOM association in order to send a verification message to a remote AE via a C-ECHO-RQ message. The GENIE Acquisition DICOM Server AE responds to the following functions: Query: Accepts a DICOM association initiated remotely in order to receive a C- FIND-RQ. Responds to incoming C-FIND-RQ messages by searching its local database for the requested attributes and returning a C-FIND-RSP message containing a match and a status of pending. All other matches are also returned in C-FIND-RSP messages with status of pending until the last message which is returned with a final status of success, warning or failure. The remote AE can terminate the query by sending a C-CANCEL- FIND-RQ message. Retrieve: Accepts a DICOM association initiated remotely in order to receive a C-MOVE-RQ. Responds to incoming C-MOVE-RQ messages by searching its local database for the requested image(s) and returning each via a C-STORE-RQ message. The DICOM Server will return a C-FIND-RSP message after each image is sent. The status returned is pending until the last image is sent, in which case the appropriate status is returned. The remote AE can terminate the retrieve by sending a C-CANCEL-MOVE-RQ message. Verify: Accepts a DICOM association initiated remotely in order to receive a C- ECHO-RQ. Responds to incoming C-ECHO-RQ messages by returning a C- ECHO-RSP message with a status of success. 2.2.3 Sequencing of Real-World Activities Non Applicable. 2.3 AE SPECIFICATIONS 2.3.1 DICOM Server AE Specification SOP Class Name This Application Entity provides Standard Conformance to the following DICOM v3.0 SOP Classes as an SCU: Modality Worklist Information Model - FIND 1.2.840.10008.5.1.4.31 Nuclear Medicine Image Storage 1.2.840.10008.5.1.4.1.1.20 SOP Class UID 2 3

Verification 1.2.840.10008.1.1 SOP Class Name This Application Entity provides Standard Conformance to the following DICOM v3.0 SOP Classes as an SCP: Patient Root Query/Retrieve Information Model FIND 1.2.840.10008.5.1.4.1.2.1.1 Patient Root Query/Retrieve Information Model MOVE 1.2.840.10008.5.1.4.1.2.1.2 Study Root Query/Retrieve Information Model FIND 1.2.840.10008.5.1.4.1.2.2.1 Study Root Query/Retrieve Information Model MOVE 1.2.840.10008.5.1.4.1.2.2.2 Verification 1.2.840.10008.1.1 SOP Class UID 2.3.1.1 Association Establishment Policies 2.3.1.1.1 General The DICOM Application Context Name (ACN), which is always proposed, is: Application Context Name 1.2.840.10008.3.1.1.1 The Maximum Length PDU negotiation is included in all association establishment requests. The maximum length PDU for an association initiated by the DICOM Server is: Maximum Length PDU 10038 bytes The SOP Class Extended Negotiation is not supported. The maximum number of Presentation Context Items that will be proposed is 8. Note that the same Abstract Syntax may be offered multiple times with different Transfer Syntaxes. The user information Items sent by this product are: Maximum PDU Length Implementation UID 2.3.1.1.2 Number of Associations The DICOM Server AE (SCU) will initiate only one DICOM association at a time to a single remote AE. A configurable number (default 2) of simultaneous DICOM associations can be open to different remote AEs. An individual association may be used either for querying worklists or for storing images. The DICOM Server AE (SCP) can have a configured number (default 4) of DICOM associations open to service queries, retrieves or verifications. 2.3.1.1.3 Asynchronous Nature Asynchronous mode is not supported. All operations are performed synchronously. 2 4

2.3.1.1.4 Implementation Identifying Information The Implementation UID for this DICOM v3.0 Implementation is: GENIE Acquisition Implementation UID 1.2.840.113619.6.105 2.3.1.2 Association Initiation Policy The DICOM Server AE initiates a new association due to an image send or worklist query operation being initiated from the GENIE Acquisition user interface or due to image data being retrieved by a remote AE. The DICOM Server AE also initiates a new association when the operator initiates a verification operation via the utility DICOMping. 2 5

2.3.1.2.1 Real-World Activity: Modality Worklist Query 2.3.1.2.1.1 Associated Real-World Activity The operator must specify the query by which a remote MWL (SCP) performs matching. The operator can specify matching by: Scheduled Station AE title Scheduled Station Name Scheduled Procedure Step Start Date Modality In addition, the operator can futher qualify a query by one of: Scheduled Procedure Step ID Requested Procedure ID Accession Number Patient Name and/or Patient ID The application will complete a query containing a Date by specifying a Scheduled Procedure Step Start Time range of daybreak to midnight. Once the query has been specified, the operator pushes the Query button to initiate the MWL query operation. The DICOM Server will then initiate an association with the remote AE in order to send the query and receive the matching worklist entries. Each Worklist response can be browsed to review most of their attributes. Some attributes do not have an operator meaning and cannot be reviewed, e.g Study DICOM UID. A Worklist response that is to be scanned, can be selected and added to the ToDo list. The application now proceeds in the same way as for non-worklist created ToDo entries. A single association is used to send the query and receive all the matches. 2 6

2.3.1.2.1.2 Proposed Presentation Context Table The following table shows the proposed presentation contexts for the DICOM Server AE after real-world activity Modality Worklist has been initiated: Presentation Context Table Proposed Abstract Syntax Transfer Syntax Role Extended Name UID Name List UID List Negotiation Modality Worklist Information Model FIND 1.2.840.10008.5.1.4.31 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None 2.3.1.2.1.2.1 SOP Specific DICOM Conformance Statement for the Modality Worklist SOP Classes Upon receiving a C-FIND confirmation containing a Refused status, this implementation will terminate the association. A C-FIND request can result in multiple C-FIND responses over a single association. Following are the status codes that are more specifically processed when receiving messages from Modality Worklist SCP equipment: Service Status Status Codes Further Meaning Application Behavior When receiving Status Codes Refused A700 Out of resources Error logged and dialog displayed to user. Failed Cxxx Unable to process Error logged and dialog displayed to user. Cancel FE00 Matching terminated due to cancel A user request to cancel the query has been actioned and is acknowledged. Cancel logged. Success 0000 Matching is complete - No final identifier is supplied Pending FF00 Matches are continuing - Current Match is supplied and any Optional Keys were supported in the same manner as Required Keys. FF01 Matches are continuing - Warning that one or more Optional Keys were not supported for existence and/or matching for this Identifier Continue receiving matches and displaying them in the Scheduled Procedure Step browser. Continue receiving matches and displaying them in the Scheduled Procedure Step browser. 2 7

2.3.1.2.2 Real-World Activity: Image Send 2.3.1.2.2.1 Associated Real-World Activity The operator must both select image(s) to be transferred from the Patient Selector and select a destination from the Network Card. Once these selections have been made, the operator pushes the Send button to initiate an image send operation. The DICOM Server will then initiate an association with the remote AE in order to send the selected image(s). Image Send activity is also initiated by Image Retrieve activity. A single association is used to send all data for a single destination. 2.3.1.2.2.2 Proposed Presentation Context Table The following table shows the proposed presentation contexts for the DICOM Server AE after real-world activity Image Send has been initiated: Presentation Context Table Proposed Abstract Syntax Transfer Syntax Role Extended Name UID Name List UID List Negotiation Nuclear Medicine Image Storage 1.2.840.10008.5.1.4.1.1.20 Implicit VR Little Endian Explicit VR Little Endian Explicit VR Big Endian 1.2.840.10008.1.2 1.2.840.10008.1.2.1 1.2.840.10008.1.2.2 SCU None 2.3.1.2.2.2.1 SOP Specific DICOM Conformance Statement for all Storage SOP Classes This implementation can perform multiple C-STORE operations over a single association. Upon receiving a C-STORE confirmation containing a Successful status, this implementation will perform the next C-STORE operation. The association will be maintained if possible. Upon receiving a C-STORE confirmation containing a Refused status, this implementation will terminate the association. Upon receiving a C-STORE confirmation containing a status other than Successful or Refused, this implementation will consider the current request to be a failure but will continue to attempt to send any remaining images in the request using the same association. If any of the above timers expires, the association is closed and the operation in progress is considered to be failed. Following are the status codes that are more specifically processed when receiving messages from Storage SCP equipment: 2 8

Service Status Status Codes Further Meaning Application Behavior When receiving Status Codes Refused A7xx Out of resources The message Image transfer failed posted to the Log card. 0122 SOP Class not Supported The message Image transfer failed posted to the Log card. Error Cxxx Cannot Understand The message Image transfer failed posted to the Log card. A9xx Data Set does not match SOP Class The message Image transfer failed posted to the Log card. Warning B000 Coercion of Data Elements The message Successful; remote warning returned posted to the network Log card. B007 Data Set does not match SOP Class The message Successful; remote warning returned posted to the network Log card. B006 Elements Discarded The message Successful; remote warning returned posted to the network Log card. Success 0000 The message Successful posted to the network Log card. 2 9

2.3.1.2.3 Real-World Activity: Verify 2.3.1.2.3.1 Associated Real-World Activity Service personnel invoke the utility DICOMping from the UNIX command line. The AE Title of the remote is supplied on the command line. The DICOM server will initiate an association with the remote DICOM AE in order to verify communication at the application level. The success or failure of the verification process is displayed to the user. The IP and port number for the echo SCP is retrieved from a configuration file. 2.3.1.2.3.2 Proposed Presentation Context Table Presentation Context Table - Proposed Abstract Syntax Transfer Syntax Role Extended Name UID Name List UID List Negotiation Verification SOP Class 1.2.840.10008.1.1 Implicit VR Little Endian 1.2.840.10008.1.2 SCU None 2.3.1.2.3.2.1 SOP Specific DICOM Conformance Statement for Verification SOP Class The DICOM Server AE provides standard conformance to the DICOM Verification Service Class. 2.3.1.3 Association Acceptance Policy The DICOM Server AE only accepts associations for which it has been configured. The DICOM Server AE responds to queries from remote AE s by returning matching entries. Any Remote AE can request and receive a list of images located in the local GENIE Acquisition database. 2 10

2.3.1.3.1 Real-World Activity: Query SCP 2.3.1.3.1.1 Associated Real-World Activity The DICOM Server AE is always listening for associations. No operator action is required to respond to Query request. The real-world activity associated with the Query request is to search the local database for all entries that match the request and send a C-FIND-RSP message with the status of pending for each matching entry. The exception to this is the last message which is sent with a status of success, failure or refused. 2.3.1.3.1.2 Accepted Presentation Context Table Presentation Context Table Accepted Abstract Syntax Transfer Syntax Role Extended Name UID Name List UID List Negotiation Patient Root Query/Retrieve Information Model - FIND Study Root Query/Retrieve Information Model - FIND 1.2.840.10008.5.1.4.1.2.1.1 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None 1.2.840.10008.5.1.4.1.2.2.1 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None Note that this implementation does not support extended negotiation for the C-FIND Service, including that for relational-queries. 2.3.1.3.1.2.1 SOP Specific DICOM Conformance Statement for the Patient Root Query/Retrieve Information Model - FIND and Study Root Query/Retrieve Information Model - FIND SOP Classes Service Status Status Codes Refused A700 Out of resources Following are the status codes the Application may send back to the SCU Equipment after performing the requested Query : Further Meaning Application Behavior When receiving Status Codes Failed C000 Unable to process Returned by the DICOM Server if for any other reason, not specified elsewhere in this table, the Find operation failed; error logged. Cancel FE00 Matching terminated due to cancel Returned if the DICOM Server receives a C-CANCEL- FIND-RQ message; cancel logged. Success 0000 Matching is complete - No final identifier is supplied Pending FF00 Matches are continuing - Current Match is supplied and any Optional Keys were supported in the same manner as Required Keys. FF01 Matches are continuing - Warning that one or more Optional Keys were not supported for existence and/or matching for this Identifier Returned when the DICOM Server completes the find operation. 2 11

2.3.1.3.1.3 Presentation Context Acceptance Criterion The Presentation Contexts that will be accepted by the DICOM Server will be the ones which the remote SCU has requested and that are supported by the GENIE Acquisition. 2.3.1.3.1.4 Transfer Syntax Selection Policies In the case that multiple transfer syntaxes are requested for a single Presentation Context then GENIE Acquisition selects the one which is listed first in the accepted presentation context table specified above. 2 12

2.3.1.3.2 Real-World Activity: Image Retrieve SCP 2.3.1.3.2.1 Associated Real-World Activity The DICOM Server AE is always listening for associations. No operator action is required to respond to an Image Retrieve request. The real-world activity associated with the Image Retrieve request is to send all images corresponding to the C-MOVE request to the specified destination AE through a separate association. 2.3.1.3.2.2 Accepted Presentation Context Table Presentation Context Table Accepted Abstract Syntax Transfer Syntax Role Extended Name UID Name List UID List Negotiation Patient Root Query/Retrieve Information Model - MOVE Study Root Query/Retrieve Information Model - MOVE 1.2.840.10008.5.1.4.1.2.1.2 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None 1.2.840.10008.5.1.4.1.2.2.2 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None Note that this implementation does not support extended negotiation for the C-MOVE Service, including that for relational-retrieve. 2.3.1.3.2.2.1 SOP Specific DICOM Conformance Statement for the Patient Root Query/Retrieve Information Model - MOVE and Study Root Query/Retrieve Information Model - MOVE SOP Classes Service Status Status Codes Following are the status codes the Application may send back to the SCU Equipment after performing the requested Retrieve : Further Meaning Refused A701 Out of resources - Unable to calculate number of matches A702 Out of resources - Unable to perform suboperations Application Behavior When receiving Status Codes A801 Move Destination Unknown Returned if the DICOM Server has no information on destination AE; error logged. Failed A900 Identifier does not match SOP Class C000 Unable to process Returned by the DICOM Server if for any other reason, not specified elsewhere in this table, the Find operation failed; error logged. Cancel FE00 Sub-operations terminated due to a Cancel indication Warning B000 Sub-operations Complete - One or more Failures. Returned if the DICOM Server receives a C-CANCEL- MOVE-RQ message. Returned upon completion if one or more of the specified images failed to transfer to the destination AE. Success 0000 Sub-operations Complete - No Failure Returned after the transfer of the last image. 2 13

Pending FF00 Sub-operations are continuing Returned after the transfer of each image except for the last. 2 14

2.3.1.3.3 Real-World Activity: Verify SCP 2.3.1.3.3.1 Associated Real-World Activity The DICOM Server AE is always listening for associations. No operator action is required to respond to a Verification request. The real-world activity associated with the Verification request is to send a C-ECHO- RSP message with a status of success to the requesting AE. 2.3.1.3.3.2 Accepted Presentation Context Table Presentation Context Table - Accepted Abstract Syntax Transfer Syntax Role Extended Name UID Name List UID List Negotiation Verification SOP Class 1.2.840.10008.1.1 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None 2.3.1.3.3.2.1 SOP Specific DICOM Conformance Statement for Verification SOP Class The DICOM Server AE provides standard conformance to the DICOM verification service class. 2.3.1.3.3.3 Presentation Context Acceptance Criterion The Presentation Contexts that will be accepted by the DICOM Server will be the ones which the remote SCU has requested and that are supported by the GENIE Acquisition. 2.3.1.3.3.4 Transfer Syntax Selection Policies In the case that multiple transfer syntaxes are requested for a single Presentation Context then GENIE Acquisition selects the one which is listed first in the accepted presentation context table specified above. 2 15

2.4 COMMUNICATION PROFILES 2.4.1 Supported Communication Stacks (PS 3.8, PS 3.9) DICOM Upper Layer (PS 3.8) is supported using TCP/IP. 2.4.2 OSI Stack The OSI Communication Stack is not supported by this implementation. 2.4.3 TCP/IP Stack The TCP/IP Communication Stack is inherited from the LynxOS real-time unix operating system. 2.4.3.1 API Not applicable to this product. 2.4.3.2 Physical Media Support DICOM is indifferent to the Physical medium over which TCP/IP executes (e.g. Ethernet V2.0,IEEE 802.3, ATM, FDDI) Note: For more information about the Physical Media available on GENIE Acquisition, please refer to the Product Data Sheet. 2.4.4 Point-to-Point Stack The Point-to-Point Communication Stack is not supported by this implementation. 2.5 EXTENSIONS / SPECIALIZATIONS / PRIVATIZATIONS 2.5.1 Standard Extended /Specialized/Private SOPs GENIE Acquisition implements the extended SOP class object NM IOD (see section 3). 2.5.2 Private Transfer Syntaxes GENIE Acquisition does not implement any private transfer syntaxes. 2 16

2.6 CONFIGURATION The GENIE Acquisition system is configured by GEMS Field Service Engineers. The DICOM configuration items below are configurable or re-configurable by a Field Service Engineer but are not accessible through the GENIE Acquisition user interface. 2.6.1 AE Title/Presentation Address Mapping GENIE Acquisition allows for the configuration of the mapping of remote AE titles to IP addresses and ports. This configuration is performed by GEMS Field Service Engineers. 2.6.2 Configurable Parameters The following parameters are configurable for the DICOM Server AE: Local AE Title (set to hostname of GENIE Acquisition computer) Local IP address Local IP netmask Local IP gateway Note that the port on which GENIE Acquisition receives DICOM incoming TCP/IP connections is 2030. The following fields are configurable for every remote DICOM AE: Remote AE Title Remote IP Address Listening TCP/IP Port Number A default router can be defined to reach remote stations. The following fields are configurable: Association Establishment Timer Store, Find, Move, Timers Inactivity Timers Maximum Length PDU Number of simultaneous associations Note: All configurations must be performed by a GE Field Engineer. 2 17

2.6.2.1 Inactivity Timers The table below specifies all of the timeouts that can be configured by a GE Field Service Engineer: Timeout Default (Seconds) Note Session 7200 This timer starts when an connection request is sent or received. The timer end either through timeout or when the connection is closed. Association 60 Association inactivity timeout. Used when no operation is in progress. Abort 60 Physical connection close timeout under abnormal conditions. C-ECHO 20 Operation inactivity timeout C-STORE 3600 Operation inactivity timeout C-FIND 3600 Operation inactivity timeout C-MOVE 3600 Operation inactivity timeout N-CREATE 3600 Operation inactivity timeout N-DELETE 3600 Operation inactivity timeout N-SET 3600 Operation inactivity timeout N-GET 3600 Operation inactivity timeout N-ACTION 3600 Operation inactivity timeout N-EVENT 3600 Operation inactivity timeout 2.7 SUPPORT OF EXTENDED CHARACTER SETS GENIE Acquisition will support only the ISO_IR 100 (ISO 8859-1:1987 Latin alphabet N 1. supplementary set) as extended character sets. 2 18

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3. NUCLEAR MEDICINE (NM) INFORMATION OBJECT IMPLEMENTATION 3.1 INTRODUCTION This section specifies the use of the DICOM NM Image IOD to represent the information included in NM images produced by this implementation. Corresponding attributes are conveyed using the module construct. The contents of this section are: 3.2 - IOD Description 3.3 - IOD Entity-Relationship Model 3.4 - IOD Module Table 3.5 - IOD Module Definition 3.2 NM IOD IMPLEMENTATION The GENIE Acquisition implementation of DICOM uses the Nuclear Medicine multiframe image format when creating image objects. In order to preserve full fidelity when transferring data to a GENIE Processing and Review station, some specialized database information is encoded as private DICOM attributes. The private data dictionary is included in section 3.6. Note that the GENIE Acquisition DICOM implementation creates separate NM images (SOP instances) for each energy window (energy set) in the acquisition. It may also create separate images (SOP instances) for each detector in the acquisition. 3.3 NM ENTITY-RELATIONSHIP MODEL The Entity-Relationship diagram for the NM Image interoperability schema is shown in Figure 3-1. In this figure, the following diagrammatic convention is established to represent the information organization : each entity is represented by a rectangular box. each relationship is represented by a diamond shaped box. the fact that a relationship exists between two entities is depicted by lines connecting the corresponding entity boxes to the relationship boxes. The relationships are fully defined with the maximum number of possible entities in the relationship shown. In other words, the relationship between Series and Image can have up to n Images per Series, but the Patient to Study relationship has 1 Study for each Patient (a Patient can have more than one Study on the system, however, each Study will contain information pertaining to that one Patient). 3 1

FIGURE 3-1 NM IMAGE ENTITY RELATIONSHIP DIAGRAM Patient 1 is the subject of Study contains 0,1 spatially defines Series creates 1 1 1 1 1,n 1 1,n Frame of Reference Equipment contains 0,n NM Image 3.3.1 ENTITY DESCRIPTIONS Please refer to DICOM Standard Part 3 (Information Object Definitions) for a description of each of the entities contained within the NM Information Object. 3.3.1.1 Patient Entity Description The Patient Entity defines the characteristics of a patient who is the subject of one or more medical studies which produce medical images. 3.3.1.2 Study Entity Description The Study Entity defines the characteristics of a medical study performed on a patient. A study is a collection of one or more series of medical images which are logically related for the purpose of diagnosing a patient. Each study is associated with exactly one patient. 3 2

3.3.1.3 Series Entity Description The Series Entity defines the attributes which are used to group images into distinct logical sets. Each series is associated with exactly one study. 3.3.1.4 Equipment Entity Description The Equipment Entity describes the particular imaging device which produced the series of images. An imaging device may produce one or more series within a study. The Equipment Entity does not describe the data acquisition or image creation Attributes used to generate images within a series. 3.3.1.5 Frame of Reference Entity Description The Frame of Reference Entity identifies the coordinate system which conveys spatial and/or temporal information of images in a series. 3.3.1.6 NM Image Entity Description The NM Image Entity defines the attributes which describe the pixel data of a NM image. The pixel data is generated on GENIE Acquisition as a direct result of patient scanning (an Original image). An image is defined by its image plane, pixel data characteristics, gray scale and/or color mapping characteristics and modality specific characteristics (acquisition parameters and image creation information). 3.3.2 GENIE Acquisition Mapping of DICOM entities TABLE 3.3-1 MAPPING OF DICOM ENTITIES TO GENIE ACQUISITION ENTITIES DICOM Patient Study Series Image Frame GENIE Acquisition Entity Patient Study Series Imageset Not Applicable 3.4 IOD MODULE TABLE Within an entity of the DICOM v3.0 NM IOD, attributes are grouped into related sets of attributes. A set of related attributes is termed a module. A module facilitates the understanding of the semantics concerning the attributes and how the attributes are related to each other. A module grouping does not infer any encoding of information into datasets. Table 3.4-1 identifies the defined modules within the entities which comprise the DICOM v3.0 NM IOD. Modules are identified by Module Name. Please refer to the DICOM v3.0 Standard Part 3 for a complete definition of the entities, modules, and attributes. 3 3

TABLE 3.4-1 NM IMAGE IOD MODULES Entity Name Module Name Reference Patient Patient 3.5.1.1 GENIE Acquisition Patient 3.5.1.2 Study General Study 3.5.2.1 Patient Study 3.5.2.2 GENIE Acquisition Study 3.5.2.3 Series General Series 3.5.3.1 NM Series 3.5.8.1 GENIE Acquisition Series 3.5.3.2 NM/PET Patient Orientation 3.5.8.1 Frame of Reference Frame of Reference 3.5.4.1 Equipment General Equipment 3.5.5.1 Image General Image 3.5.6.1 GENIE Acquisition Image 3.5.6.2 Image Pixel 3.5.6.3 NM Image Pixel 3.5.8.2 GENIE Acquisition Image Pixel 3.5.6.4 Multi-frame 3.5.6.5 NM Multi-frame 3.5.8.3 NM Image 3.5.8.4 NM Isotope 3.5.8.5 GENIE Acquisition Isotope 3.5.8.5.1 NM Detector 3.5.8.7 GENIE Acquisition Detector 3.5.8.8 NM TOMO Acquisition 3.5.8.9 GENIE Acquisition TOMO Acquisition 3.5.8.10 NM Multi-gated Acquisition 3.5.8.11 GENIE Acquisition Multi-gated Acquisition 3.5.8.12 NM Phase 3.5.8.13 NM Reconstruction Overlay Plane Multi-frame overlay Curve VOI LUT Not used. Not used. Not used. Not used. Not used. SOP Common 3.5.7.1 3.5 INFORMATION MODULE DEFINITIONS Please refer to the DICOM v3.0 Standard Part 3 (Information Object Definitions) for a description of each of the entities and modules contained within the NM Information Object. The following modules are included to convey Enumerated Values, Defined Terms, and Optional Attributes supported. Type 1 & Type 2 Attributes are also included for completeness and to define what values they may take and where these values are obtained from. It should be noted that they are the same as those defined in the DICOM v3.0 Standard Part 3 (Information Object Definitions). 3 4

3.5.1 Common Patient Entity Modules 3.5.1.1 Patient Module This section specifies the Attributes of the patient that describe and identify the patient who is the subject of a diagnostic Study. This Module contains Attributes of the patient that are needed for diagnostic interpretation of the Image and are common for all studies performed on the patient. TABLE 3.5-1 PATIENT MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Patient s Name (0010,0010) 2 Entered on To Do card, Patient Name field, or filled-in from worklist. Name is sent with PN VR individual component values if entered that way. Patient ID (0010,0020) 2 Entered on To Do card, Patient ID field, or filled-in from worklist. Patient s Birth Date (0010,0030) 2 Entered on Patient card, Date Of Birth field, or filled-in from worklist. Patient s Sex (0010,0040) 2 Entered on Patient card, Sex selection, or filled-in from worklist. Referenced Patient Sequence (0008,1120) 3 Not used. >Referenced SOP Class UID (0008,1150) 1C Not used. >Referenced SOP Instance UID (0008,1155) 1C Not used. Patient s Birth Time (0010,0032) 3 Not used. Other Patient IDs (0010,1000) 3 Entered on Patient card, Other Ids field, or filled-in from worklist. Other Patient Names (0010,1001) 3 Entered on Patient card, Other Names field, or filled-in from worklist. Ethnic Group (0010,2160) 3 Entered on Patient card, Ethnic Group field, or filled-in from worklist. Patient Comments (0010,4000) 3 Entered on Patient card, Comments field, or filled-in from worklist. 3.5.1.2 GENIE Acquisition Patient Module This section specifies the Attributes of the patient that describe and identify the patient who is the subject of a diagnostic Study. This Module contains private Attributes that convey information not contained in similar DICOM Standard v3.0 Module(s). TABLE 3.5-2 GENIE ACQUISITION PATIENT MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Patient Flags (0009,xx41) 3 Defines patient information. Patient Creation Date (0009,xx42) 3 Date of Patient Entity creation. Patient Creation Time (0009,xx43) 3 Time of Patient Entity creation. 3 5

3.5.2 Common Study Entity Modules The following Study IE Modules are common to all Composite Image IODs which reference the Study IE. These Module contain Attributes of the patient and study that are needed for diagnostic interpretation of the image. 3.5.2.1 General Study Module This section specifies the Attributes which describe and identify the study performed upon the patient. TABLE 3.5-3 GENERAL STUDY MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Study Instance UID (0020,000D) 1 Internally generated, or filled-in from worklist. Study Date (0008,0020) 2 Creation date of study entity (yyyymmdd). Study Time (0008,0030) 2 Creation time of study entity (hhmmss). Referring Physician s Name (0008,0090) 2 Entered on Study card, Referring Phys field, or filled-in from worklist. Study ID (0020,0010) 2 Entered on Study card, Processing Tag field. Accession Number (0008,0050) 2 Entered on Study card, Accession Number field, or filled-in from worklist. Study Description (0008,1030) 3 Entered on To Do card, Study Name field. Physician(s) of Record (0008,1048) 3 Not used. Name of Physician(s) Reading Study (0008,1060) 3 Entered on Study card, Reading Phys field, or filled-in from worklist. Referenced Study Sequence (0008,1110) 3 Not used. >Referenced SOP Class UID (0008,1150) 1C Not used. >Referenced SOP Instance UID (0008,1155) 1C Not used. Procedure Code Sequence (0008,1032) 3 Not used. >Code Value (0008,0100) 1C Not used. >Coding Scheme Designator (0008,0102) 1C Not used. >Coding Scheme Version (0008,0104) 1C Not used. 3.5.2.2 Patient Study Module This section defines Attributes that provide information about the Patient at the time the Study was performed. TABLE 3.5-4 PATIENTS STUDY MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Admitting Diagnoses Description (0008,1080) 3 Displayed in Worklist view, filled-in from worklist. Patient s Age (0010,1010) 3 Entered on Patient card, Age field, or filled-in from worklist. Patient s Size (0010,1020) 3 Entered on Patient card, Height field, or filled-in from worklist. Patient s Weight (0010,1030) 3 Entered on Patient card, Weight field, or filled-in from worklist. 3 6

Occupation (0010,2180) 3 Entered on Patient card, Occupation field, or filled-in from worklist. Additional Patient s History (0010,21B0) 3 Entered on Patient card, History field, or filled-in from worklist. 3.5.2.3 GENIE Acquisition Study Module This section specifies the Attributes which describe and identify the Study performed upon the Patient. This Module contains private Attributes that convey information not contained in similar DICOM Standard v3.0 Module(s). TABLE 3.5-5 GENIE ACQUISITION STUDY MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Study Flags (0009,xx11) 3 Defines study information. Study Type (0009,xx12) 3 Defines type of study. Study Comments (0013,xx26) 3 User-defined additional information about the study. 3.5.3 Common Series Entity Modules The following Series IE Modules are common to all Composite Image IODs which reference the Series IE. 3.5.3.1 General Series Module This section specifies the Attributes which identify and describe general information about the Series within a Study. TABLE 3.5-6 GENERAL SERIES MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Modality (0008,0060) 1 Internally set to NM. Series Instance UID (0020,000E) 1 Internally generated. Series Number (0020,0011) 2 Internally generated. Laterality (0020,0060) 2C Entered on Image card; sent if present. Series Date (0008,0021) 3 Date of acquisition completion. Series Time (0008,0031) 3 Time of acquisition completion. Performing Physicians Name (0008,1050) 3 Entered on Study card, or filled-in from worklist. Protocol Name (0018,1030) 3 Entered on To Do card, Study Name field. Series Description (0008,103E) 3 Entered on To Do card, Series Name field. Operators' Name (0008,1070) 3 Not used. Referenced Study Component Sequence (0008,1111) 3 Not used. >Referenced SOP Class UID (0008,1150) 1C Not used. >Referenced SOP Instance UID (0008,1155) 1C Not used. Body Part Examined (0018,0015) 3 Entered on Image card, Part field. 3 7

Patient Position (0018,5100) 2C Entered on Image card, Position selection The Defined Terms are: HFP = Head First-Prone HFS = Head First-Supine HFDR = Head First-Decubitus Right HFDL = Head First-Decubitus Left FFDR = Feet First-Decubitus Right FFDL = Feet First-Decubitus Left FFP = Feet First-Prone FFS = Feet First-Supine Smallest Pixel Value in Series (0028,0108) 3 Not used (see Image Pixel module). Largest Pixel Value in Series (0028,0109) 3 Not used (see Image Pixel module). Request Attributes Sequence (0040,0275) 3 Attributes from the ISR. > Requested Procedure ID (0040,4001) 1C Entered on Study Card or filled-in from worklist. > Scheduled Procedure Step ID (0040,0009) 1C Entered on Study Card or filled-in from worklist. > Scheduled Procedure Step Description (0040,0007) 3 Filled-in from worklist. >Scheduled Action Item Code Sequence (0040,0008) 3 Not used. >>Code Value (0008,0100) 1C Not used. >>Coding Scheme Designator (0008,0102) 1C Not used. >>Coding Scheme Version (0008,0104) 1C Not used. Performed Procedure Step ID (0040,0253) 3 Not used. Performed Procedure Step Start Date (0040,0244) 3 Not used. Performed Procedure Step Start Time (0040,0245) 3 Not used. Performed Procedure Step Description (0040,0254) 3 Not used. Performed Action Item Sequence (0040,0260) 3 Not used. >Code Value (0008,0100) 1C Not used. >Coding Scheme Designator (0008,0102) 1C Not used. >Coding Scheme Version (0008,0104) 1C Not used. 3.5.3.2 GENIE Acquisition Series Module This section specifies the Attributes which identify and describe general information about the Series within a Study. This Module contains private Attributes that convey information not contained in similar DICOM Standard v3.0 Module(s). TABLE 3.5-7 GENIE ACQUISITION SERIES MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Series Flags (0009,xx21) 3 Defines series information. User Orientation (0009,xx22) 3 User specified patient orientation. Initiation Type (0009,xx23) 3 Acquisition initiation type. The Defined Terms are: 0 = started on count rate 1 = started after time delay 2 = started manually Initiation Delay (0009,xx24) 3 Acquisition start delay time. Initiation Count Rate (0009,xx25) 3 Acquisition start count rate Number Energy Sets (0009,xx26) 3 Number of energy sets (windows). Number Detectors (0009,xx27) 3 Number of detectors. Series Comments (0009,xx2C) 3 User-defined additional information about the series. 3 8

Distance Prescribed (0009,xx2E) 3 User prescribed whole body scanning distance. Series Type (0011,xx0A) 3 Defines type of series. The Defined Terms are: 0 = static 1 = whole body 3 = multi-gated 6 = dynamic 9 = tomographic Effective Series Duration (0011,xx0B) 3 Duration of series acquisition. Number Beats (0011,xx0C) 3 Number of physiological triggers during acquisition. 3.5.4 Common Frame Of Reference Entity Modules The following Frame of Reference IE Module is common to all Composite Image IODs which reference the Frame of Reference IE. 3.5.4.1 Frame Of Reference Module This section specifies the Attributes necessary to uniquely identify a Frame Of Reference which insures the spatial relationship of Images within a Series. It also allows Images across multiple Series to share the same Frame Of Reference. This Frame Of Reference (or coordinate system) shall be constant for all Images related to a specific Frame Of Reference. GENIE Acquisition groups spatially and/or temporally related Images in the same Series. Although multiple Series in a Study may be spatially and/or temporally related, this implementation does not convey this information. TABLE 3.5-8 FRAME OF REFERENCE MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Frame of Reference UID (0020,0052) 1 See 3.5.4.1.1.1 for further explanation. Position Reference Indicator (0020,1040) 2 See 3.5.4.1.1.2 for further explanation. 3.5.4.1.1 Frame Of Reference Attribute Descriptions 3.5.4.1.1.1 Frame Of Reference UID The Frame Of Reference UID is set to a value unique to every Series. This is done because images of a given series are assumed to be spatially and/or temporally related. 3.5.4.1.1.2 Position Reference Indicator The Position Reference Indicator (0020,1040) is used to specify the part of the patient s anatomy which was used as an anatomical reference point associated with a specific Frame of Reference UID. The value of the Position Reference Indicator is entered on the Image card, Ref: field. 3 9

3.5.5 Common Equipment Entity Modules The following Equipment IE Module is common to all Composite Image IODs which reference the Equipment IE. 3.5.5.1 General Equipment Module This section specifies the Attributes which identify and describe the piece of equipment which produced a Series of Images. TABLE 3.5-9 GENERAL EQUIPMENT MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Manufacturer (0008,0070) 2 Set to GE MEDICAL SYSTEMS. Institution Name (0008,0080) 3 Set to value displayed on user interface banner. Institution Address (0008,0081) 3 Not used. Station Name (0008,1010) 3 Set to the name of station data acquired on. Institutional Department Name (0008,1040) 3 Not used. Manufacturer's Model Name (0008,1090) 3 Set to system type data acquired on. Device Serial Number (0018,1000) 3 Set to serial number data acquired on. Software Versions (0018,1020) 3 Set to GENIE Acquisition software version. Spatial Resolution (0018,1050) 3 Not used. Date of Last Calibration (0018,1200) 3 Not used. Time of Last Calibration (0018,1201) 3 Not used. Pixel Padding Value (0028,0120) 3 Not used. 3.5.6 Common Image Entity Modules The following Image IE Modules are common to all Composite Image IODs which reference the Image IE. 3.5.6.1 General Image Module This section specifies the Attributes which identify and describe an image within a particular series. TABLE 3.5-10 GENERAL IMAGE MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Image Number (0020,0013) 2 Internally generated. Patient Orientation (0020,0020) 2C Not used. Content Date (0008,0023) 2C Date of acquisition completion (yyyymmdd). Content Time (0008,0033) 2C Time of acquisition completion (hhmmss). Image Type (0008,0008) 3 See NM Image module. Acquisition Number (0020,0012) 3 Not used. Acquisition Date (0008,0022) 3 Date of acquisition completion. Acquisition Time (0008,0032) 3 Time of acquisition completion. 3 10

Acquisition Datetime (0008,002A) 3 Not used. Referenced Image Sequence (0008,1140) 3 Images from the same series acquired by the same detector >Referenced SOP Class UID (0008,1150) 1C Set to 1.2.840.10008.5.1.4.1.1.20, Nuclear Medicine Image Storage SOP Class UID. >Referenced SOP Instance UID (0008,1155) 1C Internally generated. >Referenced Frame Number (0008,1160) 3 Not used. Derivation Description (0008,2111) 3 Not used. Source Image Sequence (0008,2112) 3 Not used.. >Referenced SOP Class UID (0008,1150) 1C Not used. >Referenced SOP Instance UID (0008,1155) 1C Not used. >Referenced Frame Number (0008,1160) 3 Not used. Images in Acquisition (0020,1002) 3 Number of images in the series Image Comments (0020,4000) 3 Not used. Quality Control Image (0020,4000) 3 Not used. Burned In Annotation (0028,0301) 3 Not used. Lossy Image Compression (0028,2110) 3 Not used. Images are never compressed. Lossy Image Compression Ratio (0028,2112) 3 Not used. 3.5.6.2 GENIE Acquisition Image Module This section specifies the Attributes which identify and describe an image within a particular series. This Module contains private Attributes that convey information not contained in similar DICOM Standard v3.0 Module(s). TABLE 3.5-11 GENIE ACQUISITION IMAGE MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Radio Nuclide Name (0011,xx0D) 3 Name of radionuclide used. Dataset Name (0011,xx12) 3 Name of imageset in Starlink or Xpert format. Dataset Type (0011,xx13) 3 Defines type of dataset. The Defined Terms are: 0 = static 2 = whole body 8 = dynamic 11 = multi-gated 12 = tomographic planar Detector Number (0011,xx15) 3 Detector number image was acquired by. This field is not valid for data from more than one detector. Energy Number (0011,xx16) 3 Energy set number. RR Interval Window Number (0011,xx17) 3 R-R interval number (TIAR number). MG Bin Number (0011,xx18) 3 Multi-gated interval number. This field is not valid for data from more than one interval. Radius Of Rotation (0011,xx19) 3 Distance to the center of detector rotation. Detector Count Zone (0011,xx1A) 3 FOV zone for count-based acquisition termination criteria. The Defined Terms are: 0 = none specified 1 = total (all) counts 2 = counts in energy set 3 = counts inside an ROI 4 = counts outside an ROI Num Energy Windows (0011,xx1B) 3 Number of energy windows in energy set. 3 11

Image Orientation (0011,xx1F) 3 Orientation of the image. The Defined Terms are: 0 = no rotation, no mirroring 1 = no rotation, mirrored Table Orientation (0011,xx26) 3 Orientation of the table for whole body acquisition. The Defined Terms are: 0 = direction in/out 1 = direction left/right ROI Top Left (0011,xx27) 3 Acquisition count zone ROI, top left coordinate. ROI Bottom Right (0011,xx28) 3 Acquisition count zone ROI, bottom right coordinate. Energy Correct Name (0011,xx33) 3 Name of applied energy correction. Spatial Correct Name (0011,xx34) 3 Name of applied spatial correction. Tuning Calib Name (0011,xx35) 3 Name of applied tuning calibration data. Uniformity Correct Name (0011,xx36) 3 Name of associated uniformity correction. Acquisition Specific Correct Name (0011,xx37) 3 Name(s) of associated acquisition specific correction(s). Dataset Flags (0011,xx3F) 3 Defines dataset information. Period (0011,xx55) 3 Set to 1.0. Elapsed Time (0011,xx56) 3 Set to 1.0. Digital FOV (0011,xx10) 3 Field-of-view size. 3.5.6.3 Image Pixel Module This section specifies the Attributes that describe the pixel data of the image. TABLE 3.5-12 IMAGE PIXEL MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Samples per Pixel (0028,0002) 1 See NM Image Pixel module. Photometric Interpretation (0028,0004) 1 See NM Image Pixel module. Rows (0028,0010) 1 Will be one of the following values: 64, 128, 256, 512, 1024. Columns (0028,0011) 1 Will be one of the following values: 64, 128, 256, 512. Bits Allocated (0028,0100) 1 See NM Image Pixel module. Bits Stored (0028,0101) 1 See NM Image Pixel module. High Bit (0028,0102) 1 See NM Image Pixel module. Pixel Representation (0028,0103) 1 Set to 0001H (2 s complement). Pixel Data (7FE0,0010) 1 Acquired NM count data. Planar Configuration (0028,0006) 1C Not used. Attribute not required since Samples per Pixel (0028,0002) is always 1. Pixel Aspect Ratio (0028,0034) 1C Not used. Attribute not required since aspect ratio is always 1\1. Smallest Image Pixel Value (0028,0106) 3 Set to minimum pixel value in image. Largest Image Pixel Value (0028,0107) 3 Set to maximum pixel value in image. Red Palette Color Lookup Table Descriptor (0028,1101) 1C Not used. Green Palette Color Lookup Table Descriptor (0028,1102) 1C Not used. Blue Palette Color Lookup Table Descriptor (0028,1103) 1C Not used. Red Palette Color Lookup Table Data (0028,1201) 1C Not used. Green Palette Color Lookup Table Data (0028,1202) 1C Not used. Blue Palette Color Lookup Table Data (0028,1203) 1C Not used. 3 12

3.5.6.4 GENIE Acquisition Image Pixel Module This section specifies the Attributes that describe the pixel data of the image. This Module contains private Attributes that convey information not contained in similar DICOM Standard v3.0 Module(s). TABLE 3.5-13 GENIE ACQUISITION IMAGE PIXEL MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Byte Order (0011,xx38) 3 Defines pixel data byte order. The Defined Terms are: = little endian 66 = big endian Picture Format (0011,xx3A) 3 Set to 5 (GENIE IAP image format). Pixel Scale (0011,xx3B) 3 Set to 1.0. Pixel Offset (0011,xx3C) 3 Set to 0.0. Threshold Center (0011,xx44) 3 Set to 2048.0. Threshold Width (0011,xx45) 3 Set to 4096.0. Interpolation Type (0011,xx38) 3 Set to 2. 3.5.6.5 Multi-Frame Module This section specifies the Attributes of a Multi-frame pixel data Image. TABLE 3.5-14 MULTI-FRAME MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Number of Frames (0028,0008) 1 Set to total number of frames in image. Frame Increment Pointer (0028,0009) 1 See 3.5.6.5.1.1 for further explanation. 3.5.6.5.1 Multi-Frame Attribute Descriptions 3.5.6.5.1.1 Frame Increment Pointer See the NM Multi-frame Module for further information. 3 13

3.5.7 General Modules The SOP Common Module is mandatory for all DICOM IODs. 3.5.7.1 SOP Common Module This section defines the Attributes which are required for proper functioning and identification of the associated SOP Instances. They do not specify any semantics about the Real-World Object represented by the IOD. TABLE 3.5-15 SOP COMMON MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description SOP Class UID (0008,0016) 1 Set to 1.2.840.10008.5.1.4.1.1.20, Nuclear Medicine Image Storage SOP Class UID. SOP Instance UID (0008,0018) 1 Internally generated. Specific Character Set (0008,0005) 1C ISO_IR 100. Instance Creation Date (0008,0012) 3 Date of instance creation. Instance Creation Time (0008,0013) 3 Time of instance creation. Instance Creator UID (0008,0014) 3 Not used. 3.5.8 Nuclear Medicine Modules This Section describes Nuclear Medicine Series, and Image Modules. These Modules contain Attributes that are specific to the NM Image IOD. Note that more than one SOP Instance can be used to encode a single NM acquisition. For example, for Multi-gated Tomographic acquisitions, the data for each gate is sent in a separate SOP Instance as a separate Multi-gated Tomographic image. It is valid for the receiving AE to recombine the SOP Instances, per the structure of the NM IOD, to form a new SOP Instance. 3.5.8.1 NM/PET Patient Orientation Module This section specifies the Attributes that describe the NM Series. TABLE 3.5-16 NM/PET PATIENT ORIENTATION MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Patient Orientation Code Sequence (0054,0410) 2 Not used. > Code Value (0008,0100) 1C Not used. > Coding Scheme Designator (0008,0102) 1C Not used. > Code Meaning (0008,0104) 3 Not used. > Patient Orientation Modifier Code Sequence (0054,0412) 2C Not used. >> Code value (0008,0100) 1C Not used. >> Coding Scheme Designator (0008,0102) 1C Not used. >> Code Meaning (0008,0104) 3 Not used. Patient Gantry Relationship Code Sequence (0054,0414) 2 Not used. 3 14

> Code Value (0008,0100) 1C Not used. > Coding Scheme Designator (0008,0102) 1C Not used.. > Code Meaning (0008,0104) 3 Not used. 3.5.8.2 NM Image Pixel Module This section specifies the Attributes that describe the pixel data of a NM image. TABLE 3.5-17 NM IMAGE PIXEL MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Samples per Pixel (0028,0002) 1 Set to 1. Photometric Interpretation (0028,0004) 1 Set to Enumerated Value MONOCHROME2. Bits Allocated (0028,0100) 1 Set to 16. Bits Stored (0028,0101) 1 Set to 16. High Bit (0028,0102) 1 Set to 15. Pixel Spacing (0028,0030) 2 Set to size of pixels in image. 3.5.8.3 NM Multi-frame Module This section specifies the Attributes of a NM Multi-frame Image. This module is always included in a NM SOP instance, even if there is only one frame in the image. TABLE 3.5-18 NM MULTI-FRAME MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Frame Increment Pointer (0028,0009) 1 See 3.5.8.3.1.1 for further specialization. Energy Window Vector (0054,0010) 1C Defines energy window to which each frame belongs. Number of Energy Windows (0054,0011) 1 Set to number of energy windows in SOP Instance. Detector Vector (0054,0020) 1C Defines detector to which each frame belongs. Number of Detectors (0054,0021) 1 Set to number of detectors in SOP Instance. Phase Vector (0054,0030) 1C Defines phases to which each frame belongs. Number of Phases (0054,0031) 1C Set to number of phase in SOP Instance. Rotation Vector (0054,0050) 1C All indices set to 1. Number of Rotations (0054,0051) 1C Set to 1. R-R Interval Vector (0054,0060) 1C All indices set to 1. Number of R-R Intervals (0054,0061) 1C Set to 1. Time Slot Vector (0054,0070) 1C Defines time slot, within cardiac cycle, to which each frame belongs. Number of Time Slots (0054,0071) 1C Set to number of time slots in SOP Instance. Slice Vector (0054,0080) 1C All indices set to 1. Number of Slices (0054,0081) 1C Set to 1. Angular View Vector (0054,0090) 1C Defines angular view number to which each frame belongs. Time Slice Vector (0054,0100) 1C Defines frame numbers within each phase. 3 15

3.5.8.3.1 NM Multi-Frame Attribute Descriptions 3.5.8.3.1.1 Frame Increment Pointer The Frame Increment Pointer (0028,0009) defines which frame index vectors are present in the NM Multi-frame Module. Not all frame index vectors are present for each image type. The Frame Increment Pointer is supported per the DICOM specification for all image types defined in Table 3.5-19. TABLE 3.5-19 ENUMERATED VALUES FOR FRAME INCREMENT POINTER Image Type (0008,0008), Value 3 Frame Increment Pointer (0028,0009) STATIC or WHOLE BODY DYNAMIC GATED TOMO GATED TOMO 0054H 0010H \ 0054H 0020H Sequencing is by Energy Window Vector (0054,0010), Detector Vector (0054,0020). 0054H 0010H \ 0054H 0020H \ 0054H 0030H \ 0054H 0100H Sequencing is by Energy Window Vector (0054,0010), Detector Vector (0054,0020), Phase Vector (0054,0030), Time Slice Vector (0054,0100) 0054H 0010H \ 0054H 0020H \ 0054H 0060H \ 0054H 0070H Sequencing is by Energy Window Vector (0054,0010), Detector Vector (0054,0020), R-R Interval Vector(0054,0060), Time Slot Vector (0054,0070) 0054H 0010H \ 0054H 0020H \ 0054H 0050H \ 0054H 0090H Sequencing is by Energy Window Vector (0054,0010), Detector Vector (0054,0020), Rotation Vector (0054,0050), Angular View Vector (0054,0090) 0054H 0010H \ 0054H 0020H \ 0054H 0050H \ 0054H 0060H \ 0054H 0070H \ 0054H 0090H Sequencing is by Energy Window Vector (0054,0010), Detector Vector (0054,0020), Rotation Vector (0054,0050), R-R Interval Vector (0054,0060), Time Slot Vector (0054,0070), Angular View Vector (0054,0090). 3.5.8.4 NM Image Module This section contains the Attributes that describe Nuclear Medicine Images. TABLE 3.5-20 NM IMAGE MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Image Type (0008,0008) 1 See 3.5.8.4.1.1 for specialization. Image ID (0054,0400) 3 Set to name of imageset. Lossy Image Compression (0028,2110) 1C Not used. Images never compressed. Counts Accumulated (0018,0070) 2 Set to number of counts in imageset. Acquisition Termination Condition (0018,0071) 3 Defined Terms used: CNTS = count limit reached DENS = count limit reached within ROI MANU = manual TIME = time limit reached TRIG = number of beats limit reached Table Height (0018,1130) 3 Height of table above floor at acquisition start. Sent if system is capable of measuring this value. Table Traverse (0018,1131) 3 Table longitudinal position at acquisition start. Sent if system is capable of measuring this value. Actual Frame Duration (0018,1242) 1C Duration of each frame in imageset. 3 16

Count Rate (0018,1243) 3 Maximum count rate during image acquisition. Processing Function (0018,5020) 3 Not used. Corrected Image (0028,0051) 3 Defined Terms used: NRGY = energy corrected LIN = linearity corrected UNIF = uniformity corrected COR = center of rotation corrected NCO = non-circular orbit corrected DECY = decay corrected Whole Body Technique (0018,1301) 3 Enumerated Values used: 1PS = one pass Scan Velocity (0018,1300) 2C Whole body scan speed Scan Length (0018,1302) 2C Whole body scan length Referenced Overlay Sequence (0008,1130) 3 Not used. >Referenced SOP Class UID (0008,1150) 1C Not used. >Referenced SOP Instance UID (0008,1155) 1C Not used. Referenced Curve Sequence (0008,1145) 3 Not used. >Referenced SOP Class UID (0008,1150) 1C Not used. >Referenced SOP Instance UID (0008,1155) 1C Not used. Trigger Source or Type (0018,1061) 3 Defined Terms used: EKG Anatomic Region Sequence (0008,2218) 3 Not used. > Code Value (0008,0100) 1C Not used. > Coding Scheme Designator (0008,0102) 1C Not used. > Code Meaning (0008,0104) 3 Not used. > Anatomic Region Modifier Sequence (0008,2220) 3 Not used. >> Code Value (0008,0100) 1C Not used. >> Coding Scheme Designator (0008,0102) 1C Not used. >> Code Meaning (0008,0104) 3 Not used. Primary Anatomic Structure Sequence (0008,2228) 3 Not used. > Code Value (0008,0100) 1C Not used. > Coding Scheme Designator (0008,0102) 1C Not used. > Code Meaning (0008,0104) 3 Not used. > Primary Anatomic Structure Modifier Sequence (0008,2230) 3 Not used. >> Code Value (0008,0100) 1C Not used. >> Coding Scheme Designator (0008,0102) 1C Not used. >> Code Meaning (0008,0104) 3 Not used. 3.5.8.4.1 NM Image Module Attribute Descriptions 3.5.8.4.1.1 Image Type The following Image Type (0008,0008) values are sent: Value 1 shall have the following Enumerated Value: ORIGINAL identifies an Original Image Value 2 shall have the following Enumerated Value: PRIMARY identifies a Primary Image Value 3 shall have the following Enumerated Values: 3 17

STATIC identifies a Static Image DYNAMIC identifies a Dynamic Image GATED identifies a Multi-gated Image WHOLE BODY identifies a Whole Body Image TOMO identifies a Tomographic Image GATED TOMO identifies a Multi-gated Tomographic Image Value 4 shall have the following Enumerated Values: EMISSION transmission source NOT active during image acquisition TRANSMISSION transmission source active during image acquisition 3.5.8.5 NM Isotope Module This section contains Attributes that describe the isotope administered for the acquisition. TABLE 3.5-21 NM ISOTOPE MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Energy Window Information Sequence (0054,0012) 2 Energy window information. > Energy Window Name (0054,0018) 3 Entered on Energy Set N card, Emission Name and/or Transmission Name field. >Energy Window Range Sequence (0054,0013) 3 Sequence describing window energy limits. >> Energy Window Lower Limit (0054,0014) 3 Lower energy limit in KeV. >> Energy Window Upper Limit (0054,0015) 3 Upper energy limit in KeV. Radiopharmaceutical Information Sequence (0054,0016) 2 Information on radiopharmaceutical(s) used. > Radionuclide Code Sequence (0054,0300) 2C Not used (Zero length). >> Code Value (0008,0100) 1C Entered on Energy Isotope card, Isotope field. See 3.5.8.5.1 for specialization.. >> Coding Scheme Designator (0008,0102) 1C See 3.5.8.5.1 for specialization. >> Code Meaning (0008,0104) 3 See 3.5.8.5.1 for specialization. > Radiopharmaceutical Route (0018,1070) 3 Not used. > Administration Route Code Sequence (0054,0302) 3 Not used. >> Code Value (0008,0100) 1C Not used. >> Coding Scheme Designator (0008,0102) 1C Not used. >> Code Meaning (0008,0104) 3 Not used. > Radiopharmaceutical Volume (0018,1071) 3 Entered on Energy Isotope card, Nuclide Vol field. > Radiopharmaceutical Start Time (0018,1072) 3 Not used. > Radiopharmaceutical Stop Time (0018,1073) 3 Not used. > Radionuclide Total Dose (0018,1074) 3 Entered on Energy Isotope card, Total Dose field. > Calibration Data Sequence (0054,0306) 3 Dose information. >> Energy Window Number (0054,0308) 1C Set to 1. >> Syringe Counts (0018,1045) 3 Entered on Energy Isotope card, Dose field. >> Residual Syringe Counts (0054,0017) 3 Entered on Energy Isotope card, Residual Dose field. > Radiopharmaceutical (0018,0031) 3 Entered on Energy Isotope card, Pharm field. > Radiopharmaceutical Code Sequence (0054,0304) 3 Not used. >> Code Value (0008,0100) 1C Not used. >> Coding Scheme Designator (0008,0102) 1C Not used. >> Code Meaning (0008,0104) 3 Not used. 3 18

Intervention Drug Information Sequence (0018,0026) 3 Not used. >Intervention Drug Name (0018,0034) 3 Not used. >Intervention Drug Code Sequence (0018,0029) 3 Not used. >> Code Value (0008,0100) 1C Not used. >> Coding Scheme Designator (0008,0102) 1C Not used. >> Code Meaning (0008,0104) 3 Not used. > Administration Route Code Sequence (0054,0302) 3 Not used. >> Code Value (0008,0100) 1C Not used. >> Coding Scheme Designator (0008,0102) 1C Not used. >> Code Meaning (0008,0104) 3 Not used. >Intervention Drug Start Time (0018,0035) 3 Not used. >Intervention Drug Stop Time (0018,0027) 3 Not used. >Intervention Drug Dose (0018,0028) 3 Not used. 3.5.8.5.1 Radionuclide Code Sequence The Coding Scheme Designator (0008,0102) for the Radionuclide Code Sequence (0054,0300) shall be 99SDM representing the SNOMED DICOM Microglossary. The Code Value (0008,0100) is entered by the user. It can be any of the values from the Code Value or Alternative GE Value columns shown in the table below. The Code Meaning (0008,0104) depends on the Code Value (0008,0100) and will take one of the following enumerated values: Code Meaning (0008,0104) Code Value (0008,0100) Alternative GE Value ^18^Fluorine C-111A1 Fl18 ^123^Iodine C-114A4 I123 ^125^Iodine C-114A6 I125 ^131^Iodine C-114B1 I131 ^133^Barium C-122A5 Ba133 ^67^Gallium C-131A2 Ga67 ^201^Thallium C-138A9 Tl201 ^57^Cobalt C-144A3 Co57 ^111^Indium C-145A4 In111 ^99m^Technetium C-163A8 Tc99m ^133^Xenon C-172A8 Xe133 ^85^Krypton C-173A7 Kr85 ^153^Gadolinium C-178A8 Gd153 Not sent Other 3 19

3.5.8.6 GENIE Acquisition Isotope Module This section contains Attributes that describe the isotope administered for the acquisition. This Module contains private Attributes that convey information not contained in similar DICOM Standard v3.0 Module(s). TABLE 3.5-22 GENIE ACQUISITION ISOTOPE MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Energy Offset (0011,xx1C) 3 Energy window offset as a percentage of the energy peak. Energy Range (0011,xx1D) 3 Defines X-series detector energy range. The Defined Terms are: 0 = low energy range 1 = high energy range AutoTrack Peak (0013,xx16) 3 Optima AutoTrack energy peak. AutoTrack Width (0013,xx17) 3 Optima AutoTrack energy width. 3.5.8.7 NM Detector Module This section contains IOD Attributes that describe Nuclear Medicine Detectors used to produce an image. TABLE 3.5-23 NM DETECTOR MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Detector Information Sequence (0054,0022) 2 Detector information. > Collimator/Grid Name (0018,1180) 3 Name of collimator used on this detector. > Collimator Type (0018,1181) 2C Which Defined Terms used: PARA = Parallel PINH = Pinhole FANB = Fan-beam CONE = Cone-beam SLNT = Slant hole ASTG = Astigmatic DIVG = Diverging NONE = No collimator UNKN = Unknown > Field of View Shape (0018,1147) 3 Which Defined Terms used: RECTANGLE ROUND HEXAGONAL > Field of View Dimension(s) (0018,1149) 3 Dimensions of the field of view. > Focal Distance (0018,1182) 2C Focal distance. > X Focus Center (0018,1183) 3 Center point of the focus position. > Y Focus Center (0018,1184) 3 Center point of the focus position. > Zoom Center (0028,0032) 3 Image center offset from field of view center. > Zoom Factor (0028,0031) 3 Zoom factor, typical range: 1.00 to 4.00. > Center of Rotation Offset (0018,1145) 3 Offset between detector center and mechanical center positions. > Gantry/Detector Tilt (0018,1120) 3 Detector tilt position. 3 20

> Distance Source to Detector (0018,1110) 2C Distance between transmission source and detector during transmission scanning. > Start Angle (0054,0200) 3 Not used. > Radial Position (0018,1142) 3 Detector radial position at start of acquisition. > Image Orientation (Patient) (0020,0037) 2C Set to 1.0\0.0\0.0\0.0\0.0\-1.0. > Image Position (Patient) (0020,0032) 2C Set to 0.0\0.0\0.0. > View Code Sequence (0054,0220) 3 Not used. >> Code Value (0008,0100) 1C Not used. >> Coding Scheme Designator (0008,0102) 1C Not used. >> Code Meaning (0008,0104) 3 Not used. >> View Angulation Modifier Code Sequence (0054,0222) 2C Not used. >>> Code value (0008,0100) 1C Not used. >>> Coding Scheme Designator (0008,0102) 1C Not used. >>> Code Meaning (0008,0104) 3 Not used. 3.5.8.8 GENIE Acquisition Detector Module This section contains Attributes that describe Nuclear Medicine Detectors used to produce an image. This Module contains private Attributes that convey information not contained in similar DICOM Standard v3.0 Module(s). TABLE 3.5-24 GENIE ACQUISITION DETECTOR MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Use FOV Mask (0011,xx23) 3 Whether FOV mask used during image acquisition. The Defined Terms are: 0 = no mask used 1 = FOV mask used FOV Mask Y Cutoff Distance (0011,xx24) 3 Hexagonal FOV mask Y cutoff angle. FOV Mask Cutoff Angle (0011,xx25) 3 Hexagonal FOV mask cutoff angle. FOV Shape (0011,xx3E) 3 GEMS NM system detector type. The Defined Terms are: 1 = AC400 6 = Optima, MYOCAM 7 = MAXXUS 8 = Millennium MPS, UNICAM 9 = Millennium MPR, TOMOCAM 10 = Millennium MG, MT, MC, MAGICAM Transmission Scan Time (0013,xx18) 3 Attenuation correction transmission scan duration. Transmission Mask Width (0013,xx19) 3 Attenuation correction transmission scan mask width. Copper Attenuator Thickness (0013,xx1A) 3 Thickness of transmission scan copper attenuator. 3.5.8.9 NM TOMO Acquisition Module This section contains Attributes that describe Rotation information of a tomographic image performed on the patient. This module is present when the Image Type (0008,0008) Value 3, is equal to TOMO or GATED TOMO. 3 21

TABLE 3.5-25 NM TOMO ACQUISITION MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Rotation Information Sequence (0054,0052) 2 Provides TOMO rotation information. > Start Angle (0054,0200) 1C Trailing detector start angle at start of acquisition. > Angular Step (0018,1144) 1C Incremental rotational angle change per view. > Rotation Direction (0018,1140) 1C Direction of rotation. > Scan Arc (0018,1143) 1C Total rotation angle. > Actual Frame Duration (0018,1242) 1C Duration of a view. > Radial Position (0018,1142) 3 Detector radial position at start of acquisition. > Distance Source to Detector (0018,1110) 2C Distance between transmission source and detector during transmission scanning. > Number of Frames in Rotation (0054,0053) 1C Number of tomographic views acquired. > Table Traverse (0018,1131) 3 Table longitudinal position at acquisition start. > Table Height (0018,1130) 3 Height of table above floor at acquisition start. Type of Detector Motion (0054,0202) 3 Enumerated Values used: STEP AND SHOOT = Interrupted motion, acquire only while stationary. CONTINUOUS = Gantry motion and acquisition are simultaneous and continuous. ACQ DURING STEP = Interrupted motion, acquisition is continuous. 3.5.8.10 GENIE Acquisition TOMO Acquisition Module This section contains Attributes that describe Rotation information of a tomographic acquisition image performed on the patient. This Module contains private Attributes that convey information not contained in similar DICOM Standard v3.0 Module(s). TABLE 3.5-26 GENIE ACQUISITION TOMO ACQUISITION MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Gantry Locus Type (0009,xx35) 3 Locus type of gantry motion during acquisition. The Defined Terms are: 0 = circular 1 = elliptical Tomo View Offset (0013,xx1E) 3 Table of offsets from COR during acquisition. 3.5.8.11 NM Multi-gated Acquisition Module This section contains Attributes that describe a multi-gated acquisition performed on the patient. This refers to frames acquired while the patient is connected to a gating device. This module is present when the Image Type (0008,0008) Value 3, is equal to GATED or GATED TOMO. TABLE 3.5-27 NM MULTI-GATED ACQUISITION MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description 3 22

Beat Rejection Flag (0018,1080) 3 Whether a bad beat rejection algorithm used. Enumerated values: Y = bad beat rejection algorithm used N = bad beat rejection algorithm NOT used PVC Rejection (0018,1085) 3 Set to AMGB buffered beats with single acceptance window. Skip Beats (0018,1086) 3 Set to 1. Heart Rate (0018,1088) 3 Average heart rate during acquisition. Gated Information Sequence (0054,0062) 2C One sequence item present. > Trigger Time (0018,1060) 3 Not used. > Framing Type (0018,1064) 3 Not used. > Data Information Sequence (0054,0063) 2C One sequence item present. >> Frame Time (0018,1063) 1C Gated frame duration in the imageset. >> Nominal Interval (0018,1062) 3 Not used. >> Low R-R Value (0018,1081) 3 Minimum R-R interval value accepted. >> High R-R Value (0018,1082) 3 Maximum R-R interval value accepted. >> Intervals Acquired (0018,1083) 3 Number of accepted intervals. >> Intervals Rejected (0018,1084) 3 Number of rejected intervals. >> Time Slot Information Sequence (0054,0072) 2C Not used. >>> Time Slot Time (0054,0073) 3 Not used. 3.5.8.12 GENIE Acquisition Multi-gated Acquisition Module This section contains Attributes that describe a multi-gated acquisition performed on the patient. This refers to frames acquired while the patient is connected to a gating device. This Module contains private Attributes that convey information not contained in similar DICOM Standard v3.0 Module(s). TABLE 3.5-28 GENIE ACQUISITION MULTI-GATED ACQUISITION MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Starting Heart Rate (0009,xx37) 3 Heart rate at start of acquisition. Track Beat Average (0009,xx2D) 3 Whether heart rate tracking used during acquisition. RR Window Width (0009,xx38) 3 Width of RR acceptance window as percentage of rate. RR Window Offset (0009,xx39) 3 Offset of RR acceptance window as percentage of rate. Percent Cycle Imaged (0009,xx3A) 3 Percentage of RR cycle imaged. 3.5.8.13 NM Phase Module This section contains Attributes that describe dynamic phases of a dynamic acquisition image performed on the patient. This module is present when the Image Type (0008,0008) Value 3, is equal to DYNAMIC. TABLE 3.5-29 NM PHASE MODULE ATTRIBUTES Attribute Name Tag Type Attribute Description Phase Information Sequence (0054,0032) 2C One sequence item per dynamic phase. > Phase Delay (0054,0036) 1C Set to 0. 3 23

> Actual Frame Duration (0018,1242) 1C Duration of all frames in this phase. > Pause Between Frames (0054,0038) 1C Set to 0. > Number of Frames in Phase (0054,0033) 1C Number of frames in this phase. >Trigger Vector (0054,0210) 3 A string of the form T1\T2\T3\ \ >Number of Triggers in Phase (0054,0211) 1C Number of triggers in this phase 3.6 PRIVATE DATA DICTIONARY This section provides value representation and multiplicity information for all of the Private Attributes used by this implementation. Private Attributes contained within the Information Model are described in the preceding sections. TABLE 3.6-1 PRIVATE CREATOR IDENTIFICATION (GEMS_GENIE_1) Attribute Name Tag VR VM Private Creator Identification (0009,0010) LO 1 Study Flags (0009,xx11) SL 1 Study Type (0009,xx12) SL 1 Series Flags (0009,xx21) SL 1 User Orientation (0009,xx22) SH 1 Initiation Type (0009,xx23) SL 1 Initiation Delay (0009,xx24) SL 1 Initiation Count Rate (0009,xx25) SL 1 Number Energy Sets (0009,xx26) SL 1 Number Detectors (0009,xx27) SL 1 Series Comments (0009,xx2C) LO 1 Track Beat Average (0009,xx2D) SL 1 Distance Prescribed (0009,xx2E) FD 1 Gantry Locus Type (0009,xx35) SL 1 Starting Heart Rate (0009,xx37) SL 1 RR Window Width (0009,xx38) SL 1 RR Window Offset (0009,xx39) SL 1 Percent Cycle Imaged (0009,xx3A) SL 1 Patient Flags (0009,xx41) SL 1 Patient Creation Date (0009,xx42) DA 1 Patient Creation Time (0009,xx43) TM 1 Private Creator Identification (0011,0010) LO 1 Series Type (0011,xx0A) SL 1 Effective Series Duration (0011,xx0B) SL 1 Num Beats (0011,xx0C) SL 1 Radio Nuclide Name (0011,xx0D) LO 1 Dataset Name (0011,xx12) LO 1 Dataset Type (0011,xx13) SL 1 Detector Number (0011,xx15) SL 1 Energy Number (0011,xx16) SL 1 RR Interval Window Number (0011,xx17) SL 1 MG Bin Number (0011,xx18) SL 1 Radius Of Rotation (0011,xx19) FD 1 3 24

Detector Count Zone (0011,xx1A) SL 1 Num Energy Windows (0011,xx1B) SL 1 Energy Offset (0011,xx1C) SL 4 Energy Range (0011,xx1D) SL 1 Image Orientation (0011,xx1F) SL 1 Use FOV Mask (0011,xx23) SL 1 FOV Mask Y Cutoff Angle (0011,xx24) SL 1 FOV Mask Cutoff Angle (0011,xx25) SL 1 Table Orientation (0011,xx26) SL 1 ROI Top Left (0011,xx27) SL 2 ROI Bottom Right (0011,xx28) SL 2 Energy Correct Name (0011,xx33) LO 1 Spatial Correct Name (0011,xx34) LO 1 Tuning Calib Name (0011,xx35) LO 1 Uniformity Correct Name (0011,xx36) LO 1 Acquisition Specific Correction Name (0011,xx37) LT 1 Byte Order (0011,xx38) SL 1 Picture Format (0011,xx3A) SL 1 Pixel Scale (0011,xx3B) FD 1 Pixel Offset (0011,xx3C) FD 1 FOV Shape (0011,xx3E) SL 1 Dataset Flags (0011,xx3F) SL 1 Threshold Center (0011,xx44) FD 1 Threshold Width (0011,xx45) FD 1 Interpolation Type (0011,xx46) SL 1 Period (0011,xx55) FD 1 Elapsed Time (0011,xx56) FD 1 Private Creator Identification (0013,0010) LO 1 Digital FOV (0013,xx10) FD 2 AutoTrack Peak (0013,xx16) SL 1 AutoTrack Width (0013,xx17) SL 1 Transmission Scan Time (0013,xx18) FD 1 Transmission Mask Width (0013,xx19) FD 1 Copper Attenuator Thickness (0013,xx1A) FD 1 Tomo View Offset (0013,xx1E) FD 1-n Study Comments (0013,xx26) LT 1 3 25

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4. PATIENT ROOT QUERY/RETRIEVE INFORMATION MODEL DEFINITION 4.1 INTRODUCTION This section specifies the use of the DICOM Patient Root Query/Retrieve Model used to organize data and against which a Query/Retrieve will be performed. The contents of this section are: 4.2 - Information Model Description 4.3- Information Model Entity-Relationship Model 4.4 - Information Model Keys 4.2 PATIENT ROOT INFORMATION MODEL DESCRIPTION The Patient Root Query/Retrieve Information Model is based upon a four level hierarchy: Patient Study Series Image The patient level is the top level and contains Attributes associated with the Patient Information Entity (IE) of Image IODs. Patient IEs are modality independent. The study level is below the patient level and contains Attributes associated with the Study IE of Image IODs. A study belongs to a single patient. A single patient may have multiple studies. Study IEs are modality independent. The series level is below the study level and contains Attributes associated with the Series, Frame of Reference and Equipment IEs of Image IODs. A series belongs to a single study. A single study may have multiple series. Series IEs are modality dependent The lowest level is the image level and contains Attributes associated with the Image IE of Image IODs. An image belongs to a single series. A single series may contain multiple images. Image IEs are modality dependent 4.3 PATIENT ROOT INFORMATION MODEL ENTITY-RELATIONSHIP MODEL The Entity-Relationship diagram for the Patient Root Information Model schema is shown in Figure 4-1. In this figure, the following diagrammatic convention is established to represent the information organization : each entity is represented by a rectangular box each relationship is represented by a diamond shaped box. the fact that a relationship exists between two entities is depicted by lines connecting the corresponding entity boxes to the relationship boxes. 4-1

The relationships are fully defined with the maximum number of possible entities in the relationship shown. In other words, the relationship between Series and Image can have up to n Images per Series, but the Patient to Study relationship has 1 Study for each Patient (a Patient can have more than one Study on the system, however each Study will contain all of the information pertaining to that Patient). FIGURE 4-1 PATIENT ROOT QUERY/RETRIEVE INFORMATION MODEL E/R DIAGRAM Patient 1 is the subject of Study 1,n 1 contains 1,n Series 1 contains Image 0,n 4.3.1 ENTITY DESCRIPTIONS Please refer to the DICOM v3.0 Standard PS 3.4 (Service Class Specifications) for a description of each of the levels contained within the Patient Root Query/Retrieve Information Model. 4.3.1.1 Patient Entity Description The Patient Entity defines the characteristics of a patient who is the subject of one or more medical studies which produce medical images. 4-2

4.3.1.2 Study Entity Description The Study Entity defines the characteristics of a medical study performed on a patient. A study is a collection of one or more series of medical images which are logically related for the purpose of diagnosing a patient. Each study is associated with exactly one patient. 4.3.1.3 Series Entity Description The Series Entity defines the attributes which are used to group images into distinct logical sets. Each series is associated with exactly one study. 4.3.1.4 Image Entity Description The Image Entity defines the attributes which describe the pixel data of an image. The pixel data is generated as a direct result of patient scanning (an Original image). An image is defined by its image plane, pixel data characteristics gray scale and/or color mapping characteristics and modality specific characteristics (acquisition parameters and image creation information). 4.3.2 GENIE Acquisition Mapping of DICOM Entities TABLE 4.3-1 MAPPING OF DICOM ENTITIES TO GENIE ACQUISITION ENTITIES DICOM Patient Study Series Image GENIE Acquisition Entity Patient Study Series Imageset 4.4 INFORMATION MODEL KEYS Please refer to the DICOM v3.0 Standard PS 3.4 (Service Class Specifications) for a description of each of the levels contained within the Patient Root Query/Retrieve Information Model. The following Level descriptions are included to specify which data elements are supported and what type of filtering can be applied. It should be noted that they are the same ones as defined in the DICOM v3.0 Standard PS 3.4 (Service Class Specifications). 4.4.1 Supported Filtering Following are the types of matching that are supported by this implementation : Single Value matching Wild Card Matching Range of date, Range of Time 4-3

4.4.2 Patient Level This section defines the keys at the Patient Level of the Patient Root Query/Retrieve Information Model that are supported by this implementation. TABLE 4.4-1 PATIENT LEVEL ATTRIBUTES FOR THE PATIENT ROOT QUERY/RETRIEVE INFORMATION MODEL Attribute Name Tag Type Note Patient s Name (0010,0010) R Matched. Matching performed without regard to the PN VR individual component values. Patient ID (0010,0020) U Matched. Patient Birth Date (0010,0030) O Matched TABLE 4.4-2 Q/R PATIENT LEVEL AND LOCATION FOR RETRIEVE ATTRIBUTES Attribute Name Tag Type Note Query Retrieve Level (0008,0052) - Value = PATIENT Retrieve AE Title (0008, 0054) - Value = AE Title of SCP. 4.4.3 Study Level This section defines the keys at the Study Level of the Patient Root Query/Retrieve Information Model that are supported by this implementation. TABLE 4.4-3 STUDY LEVEL ATTRIBUTES FOR THE PATIENT ROOT QUERY/RETRIEVE INFORMATION MODEL Attribute Name Tag Type Note Study Date (0008,0020) R Matched. Study Time (0008,0030) R Matched. Accession Number (0008,0050) R NOT Matched in GENIE Acquisition R2.3.1 and R2.3.2. Matched in GENIE Acquisition R2.3.3. Study ID (0020,0010) R Matched. Study Instance UID (0020,000D) U Matched. Study Description (0008,1030) O Matched. TABLE 4.4-4 Q/R STUDY LEVEL AND LOCATION FOR RETRIEVE ATTRIBUTES Attribute Name Tag Type Note Query Retrieve Level (0008,0052) - Value = STUDY Retrieve AE Title (0008, 0054) - Value = AE Title of SCP. 4.4.4 Series Level This section defines the keys at the Series Level of the Patient Root Query/Retrieve Information Model that are supported by this implementation. 4-4

TABLE 4.4-5 SERIES LEVEL ATTRIBUTES FOR THE PATIENT ROOT QUERY/RETRIEVE INFORMATION MODEL Attribute Name Tag Type Note Modality (0008,0060) R Matched. Series Number (0020,0011) R Matched. Series Instance UID (0020,000E) U Matched. Series Date (0008,0021) O Matched. Series Time (0008,0031) O Matched. Series Description (0008,103E) O Returned. TABLE 4.4-6 Q/R SERIES LEVEL AND LOCATION FOR RETRIEVE ATTRIBUTES Attribute Name Tag Type Note Query Retrieve Level (0008,0052) - Value = SERIES Retrieve AE Title (0008, 0054) - Value = AE Title of SCP. 4.4.5 Image Level This section defines the keys at the Image Level of the Patient Root Query/Retrieve Information Model that are supported by this implementation. TABLE 4.4-7 IMAGE LEVEL ATTRIBUTES FOR THE PATIENT ROOT QUERY/RETRIEVE INFORMATION MODEL Attribute Name Tag Type Note Image Number (0020,0013) R Matched. SOP Instance UID (0008,0018) U Matched. Image Type (0008,0008) O Returned. Image ID (0054,0400) O Returned. Rows (0028,0010) O Returned. Columns (0028,0011) O Returned. Number of Frames (0028,0008) O Returned. TABLE 4.4-8 Q/R IMAGE LEVEL AND LOCATION FOR RETRIEVE ATTRIBUTES Attribute Name Tag Type Note Query Retrieve Level (0008,0052) - Value = IMAGE Retrieve AE Title (0008, 0054) - Value = AE Title of SCP. 4.5 PRIVATE DATA DICTIONARY There are no private query key attributes defined for this implementation. 4-5

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5. STUDY ROOT QUERY/RETRIEVE INFORMATION MODEL DEFINITION 5.1 INTRODUCTION This section specifies the use of the DICOM Study Root Query/Retrieve Model used to organize data and against which a Query/Retrieve will be performed. The contents of this section are: 5.2 - Information Model Description 5.3 - Information Model Entity-Relationship Model 5.4 - Information Model Keys 5.2 STUDY ROOT INFORMATION MODEL DESCRIPTION The Study Root Query/Retrieve Information Model is based upon a three level hierarchy: Study Series Image The study level is the top level and contains Attributes associated with the Study IE of Image IODs. Attributes of patients are considered to be attributes of studies. Study IEs are modality independent. The series level is below the study level and contains Attributes associated with the Series, Frame of Reference and Equipment IEs of Image IODs. A series belongs to a single study. A single study may have multiple series. Series IEs are modality dependent The lowest level is the image level and contains Attributes associated with the Image IE of Image IODs. An image belongs to a single series. A single series may contain multiple images. Image IEs are modality dependent 5.3 STUDY ROOT INFORMATION MODEL ENTITY-RELATIONSHIP MODEL The Entity-Relationship diagram for the Study Root Information Model schema is shown in Figure 5-1. In this figure, the following diagrammatic convention is established to represent the information organization: each entity is represented by a rectangular box each relationship is represented by a diamond shaped box. the fact that a relationship exists between two entities is depicted by lines connecting the corresponding entity boxes to the relationship boxes. The relationships are fully defined with the maximum number of possible entities in the relationship shown. In other words, the relationship between Series and Image can have up to n Images per Series. 5 1

FIGURE 5-1 STUDY ROOT QUERY/RETRIEVE INFORMATION MODEL E/R DIAGRAM Study 1 contains 1,n Series 1 contains Image 0,n 5.3.1 Entity Descriptions Please refer to the DICOM v3.0 Standard PS 3.4 (Service Class Specifications) for a description of each of the levels contained within the Study Root Query/Retrieve Information Model. 5.3.1.1 Study Entity Description The Study Entity defines the characteristics of a medical study performed on a patient. A study is a collection of one or more series of medical images which are logically related for the purpose of diagnosing a patient. Each study is associated with exactly one patient. 5.3.1.2 Series Entity Description The Series Entity defines the attributes which are used to group images into distinct logical sets. Each series is associated with exactly one study. 5.3.1.3 Image Entity Description The Image Entity defines the attributes which describe the pixel data of an image. The pixel data is generated as a direct result of patient scanning (an Original image). An image is defined by its image plane, pixel data characteristics gray scale and/or color mapping characteristics and modality specific characteristics (acquisition parameters and image creation information). 5 2

5.3.2 GENIE ACQUISITION Mapping of DICOM Entities TABLE 5.3-1 MAPPING OF DICOM ENTITIES TO GENIE ACQUISITION ENTITIES DICOM Study Series Image GENIE Acquisition Entity Study Series Imageset 5.4 INFORMATION MODEL KEYS Please refer to the DICOM v3.0 Standard PS 3.4 (Service Class Specifications) for a description of each of the levels contained within the Study Root Query/Retrieve Information Model. The following Level descriptions are included to specify what data elements are supported and what type of filtering can be applied. It should be noted that they are the same ones as defined in the DICOM v3.0 Standard PS 3.4 (Service Class Specifications). 5.4.1 Supported Filtering Following are the types of matching that are supported by this implementation : Single Value matching Wild Card Matching Range of date, Range of Time 5.4.2 Study Level This section defines the keys at the Study Level of the Study Root Query/Retrieve Information Model that are supported by this implementation. TABLE 5.4-1 STUDY LEVEL ATTRIBUTES FOR THE STUDY ROOT QUERY/RETRIEVE INFORMATION MODEL Attribute Name Tag Type Attribute Description Study Date (0008,0020) R Matched. Study Time (0008,0030) R Matched. Accession Number (0008,0050) R NOT matched in GENIE Acquisition R2.3.1 and R2.3.2. Matched in GENIE Acquisition R2.3.3. Patient s Name (0010,0010) R Matched. Matching performed without regard to the PN VR individual component values. Patient ID (0010,0020) R Matched. Study ID (0020,0010) R Matched. Study Instance UID (0020,000D) U Matched. Study Description (0008,1030) O Matched. 5 3

TABLE 5.4-2 Q/R STUDY LEVEL AND LOCATION FOR RETRIEVE ATTRIBUTES Attribute Name Tag Type Note Query Retrieve Level (0008,0052) - Value = STUDY Retrieve AE Title (0008, 0054) - Value = AE Title of SCP. 5.4.3 Series Level This section defines the keys at the Series Level of the Study Root Query/Retrieve Information Model that are supported by this implementation. TABLE 5.4-3 SERIES LEVEL ATTRIBUTES FOR THE STUDY ROOT QUERY/RETRIEVE INFORMATION MODEL Attribute Name Tag Type Attribute Description Modality (0008,0060) R Matched. Series Number (0020,0011) R Matched. Series Instance UID (0020,000E) U Matched. Series Date (0008,0021) O Matched. Series Time (0008,0031) O Matched. Series Description (0008,103E) O Returned. TABLE 5.4-4 Q/R SERIES LEVEL AND LOCATION FOR RETRIEVE ATTRIBUTES Attribute Name Tag Type Note Query Retrieve Level (0008,0052) - Value = SERIES Retrieve AE Title (0008, 0054) - Value = AE Title of SCP. 5.4.4 Image Level This section defines the keys at the Image Level of the Study Root Query/Retrieve Information Model that are supported by this implementation. TABLE 5.4-5 IMAGE LEVEL ATTRIBUTES FOR THE STUDY ROOT QUERY/RETRIEVE INFORMATION MODEL Attribute Name Tag Type Attribute Description Image Number (0020,0013) R Matched. SOP Instance UID (0008,0018) U Matched. Image Type (0008,0008) O Returned. Rows (0028,0010) O Returned. Columns (0028,0011) O Returned. Number of Frames (0028,0008) O Returned. TABLE 5.4-6 Q/R IMAGE LEVEL AND LOCATION FOR RETRIEVE ATTRIBUTES Attribute Name Tag Type Note Query Retrieve Level (0008,0052) - Value = IMAGE Retrieve AE Title (0008, 0054) - Value = AE Title of SCP. 5 4

5.5 PRIVATE DATA DICTIONARY There are no private query key attributes defined for this implementation. This Page Intentionally Left Blank 5 5

6. MODALITY WORKLIST INFORMATION MODEL DEFINITION 6.1 INTRODUCTION This section specifies the use of the DICOM Modality Worklist Information Model used to organize data and against which a Modality Worklist Query will be performed. The contents of this section are: 6.2 - Information Model Description 6.3- Information Model Entity-Relationship Model 6.4- Information Model Module Table 6.5- Information Model Keys 6.2 MODALITY WORKLIST INFORMATION MODEL DESCRIPTION In order to serve as a Service Class User (SCU) of the Modality Worklist service class, a DICOM Application Entity (AE) retrieves information about the attributes of a number of managed worklist items. These items are organised into Modality Worklist Information modules. In this service class, the Information Model plays a role similar to an Information Object Definition of most other DICOM Service Classes. 6.3 MODALITY WORKLIST INFORMATION MODEL ENTITY-RELATIONSHIP MODEL The Entity-Relationship diagram for the Modality Worklist Information Model schema is shown in Illustration 6.3-1. It represents the information that composes a Worklist Item. In this figure, the following diagrammatic convention is established to represent the information organization : each entity is represented by a rectangular box each relationship is represented by a diamond shaped box. the fact that a relationship exists between two entities is depicted by lines connecting the corresponding entity boxes to the relationship boxes. 6-1

FIGURE 6.3-1 MODALITY WORKLIST INFORMATION MODEL E/R DIAGRAM Scheduled Procedure Step Worklist Item contained in 1 Requested Procedure requested for 1 Imaging Service Request done for Patient 1 is included 0,1 Visit 6.3.1 ENTITY DESCRIPTIONS Please refer to DICOM Standard PS 3.3. (Information Object Definitions) and PS 3.4 (Service Class Specifications) for a description of each of the Entities contained within the Modality Worklist Information Model. 6.3.1.1 Scheduled Procedure Step A Scheduled Procedure Step is an arbitrarily defined scheduled unit of service that is specified by the Procedure Plan for a Requested Procedure. It specifies one or more Action Items (events) involving equipment (i.e. imaging modality equipment), human resources, location and time (i.e. start time, stop time, duration). 6-2

6.3.1.2 Requested Procedure Entity Description A Requested Procedure is an instance of a Procedure of a given Procedure Type. An instance of a Requested Procedure includes all of the items of information that are specified by an instance of a Procedure Plan that is selected for the Requested Procedure by the imaging service provider. 6.3.1.3 Imaging Service Request Entity Description An Imaging Service Request is a set of one or more Requested Procedures selected from a list of Procedure Types. An Imaging Service Request is submitted by one authorized imaging service requester to one authorized imaging service provider in the context of one Service Episode. 6.3.1.4 Visit Entity Description A Visit is the context in which the treatment or management of an arbitrary subset of a Patient s medical conditions occurs. A Visit is limited to the description of a Patient s activities at a single facility. 6.3.1.5 Patient Entity Description A Patient is a person receiving, or registered to receive, healthcare services. 6-3

6.3.2 GENIE Acquisition Mapping of DICOM entities TABLE 6.3-1 MAPPING OF DICOM ENTITIES TO GENIE ACQUISITION ENTITIES DICOM Scheduled Procedure Step Requested Procedure Imaging Service Request Visit Patient GENIE Acquisition Entity Prescription (Series) Prescription (Series) / Study Study Study Patient 6.4 INFORMATION MODEL MODULE TABLE Within an entity of the DICOM v3.0 Modality Worklist Information Model, attributes are grouped into related set of attributes. A set of related attributes is termed a module. A module facilitates the understanding of the semantics concerning the attributes and how the attributes are related with each other. A module grouping does not infer any encoding of information into datasets. Table 1.4-1 identifies the defined modules within the entities which comprise the DICOM v3.0 Modality Worklist Information Model. Modules are identified by Module Name. See DICOM v3.0 PS 3.3 and PS 3.4 for a complete definition of the entities, modules, and attributes. TABLE 6.4-1 MODALITY WORKLIST INFORMATION MODEL MODULES Entity Name Module Name Reference Scheduled Procedure Step SOP Common 6.5.2.1 Scheduled Procedure Step 6.5.2.2 Requested Procedure Requested Procedure 6.5.3.1 Imaging Service Request Imaging Service Request 6.5.4.1 Visit Visit Identification 6.5.5.1 Visit Status 6.5.5.2 Visit Relationship 6.5.5.3 Visit Admission 6.5.5.4 Patient Patient Relationship 6.5.6.1 Patient Identification 6.5.6.2 Patient Demographic 6.5.6.3 Patient Medical 6.5.6.4 6-4

6.5 INFORMATION MODEL KEYS Please refer to DICOM Standard PS 3.3. (Information Object Definitions) and PS 3.4 (Service Class Specifications) for a description of each of the Entities contained within the Modality Worklist Information Model. The following Module descriptions are included to specify what data elements are supported and what type of matching can be applied. It should be noted that they are the same ones as defined in the DICOM v3.0 Standard PS 3.4 (Service Class Specifications). A row of each table describes: Attribute Name Tag (Group, Element) Expected Matching Key Type (R-required, O-optional) Expected Returned Key Type: 1 non-zero value required 1C conditionally of type 1 2 required to be present, possibly zero-length 2C conditionally of type 2 3 optional Mapped Into The Image (field mapped into Image transfers) Notes (clarification of this implementation s use/treatment of this attribute) All of the attributes listed are included in the Modality Worklist query. 6.5.1 Supported Matching Following are the types of matching that can be request by the implementation : Single Value matching Universal Matching Wild Card Matching Range of date, Range of Time 6-5

6.5.2 Scheduled Procedure Step Entity 6.5.2.1 SOP Common Module TABLE 6.5-1 SOP COMMON MODULE ATTRIBUTES Attribute Name Tag Expected Matching Key Type Expected Returned Key Type Mapped into the Image Specific Character Set (0008,0005) O 1C No Matching is supported, the matching value=iso_ir100 is fixed. Note 6.5.2.2 Scheduled Procedure Step Module TABLE 6.5-2 SCHEDULED PROCEDURE STEP MODULE ATTRIBUTES Attribute Name Tag Expected Matching Key Type Scheduled Procedure Step Sequence Expected Returned Key Type Mapped into the Image (0040,0100) R 1 No >Scheduled Station AE Title (0040,0001) R 1 No Matching supported. Universal or Single Value. If user specifies a station name then it s AE title is determined from configuration. >Scheduled Procedure Step Start Date >Scheduled Procedure Step Start Time >Scheduled Procedure Step End Date Note (0040,0002) R 1 No Matching Supported. Specified as range of date of the form: Date-Date where Date can be specified as one of: yyyymmdd or * (0040,0003) R 1 No Matching supported. Specified as time range of time of the forrm: Time1-Time2 where time can be specified as: hhmmss.frac or * (0040,0004) O 3 No 6-6

>Scheduled Procedure Step End Time (0040,0005) O 3 No >Modality (0008,0060) R 1 No Matching Supported. Single value matching performed. Images transferred always have Value=NM >Scheduled Performing Physician s Name >Scheduled Procedure Step Description (0040,0006) R 2 Yes Matching Supported. Universal, Single or Wildcard. Mapped to image field (0008, 1050) performing physicians name. (0040,0007) O 1C No >Scheduled Station Name (0040,0010) O 2 No Matching supported. Universal or Single Value. Used in conjunction with (0040,0001) Scheduled Station AE Title. >Pre-Medication (0040,0012) O 2C No >Scheduled Procedure Step ID (0040,0009) O 1 No Matching Supported. Universal, Single or Wildcard. >Requested Contrast Agent (0032,1070) O 2C No >Scheduled Procedure Step Status (0040,0020) O 3 No >Comments on the Scheduled Procedure Step (0040,0400) O 3 No 6.5.3 Requested Procedure Entity 6.5.3.1 Requested Procedure Module TABLE 6.5-3 REQUESTED PROCEDURE MODULE ATTRIBUTES Attribute Name Tag Expected Matching Key Type Expected Returned Key Type Mapped into the Image Requested Procedure ID (0040,1001) O 1 No Matching supported. Universal, Single value, Wildcard. Requested Procedure Description (0032,1060) O 1C No Study Instance UID (0020,000D) O 1 Yes Requested Procedure Priority (0040,1003) O 2 No Patient Transport Arrangements (0040,1004) O 2 No Reason for the Requested Procedure (0040,1002) O 3 No Note 6-7

Requested Procedure Comments (0040,1400) O 3 No Requested Procedure Location (0040,1005) O 3 No Names of Intended Recipients Of Results (0040,1010) O 3 Yes Mapped to image field (0008,1060) Names of Physicians Reading Study 6.5.4 Imaging Service Request Entity 6.5.4.1 Imaging Service Request Module TABLE 6.5-4 IMAGING SERVICE REQUEST MODULE ATTRIBUTES Attribute Name Tag Expected Matching Key Type Expected Returned Key Type Mapped into the Image Accession Number (0008,0050) O 2 Yes Matching Supported. Universal, Single Value, Wildcard. Requesting Physician (0032,1032) O 2 No Referring Physician s Name (0008,0090) O 2 Yes Reason for the Imaging Service Request (0040,2001) O 3 No Imaging Service Request Comments (0040,2400) O 3 No Note 6.5.5 Visit Entity 6.5.5.1 Visit Identification TABLE 6.5-5 VISIT IDENTIFICATION MODULE ATTRIBUTES Attribute Name Tag Expected Matching Key Type Expected Returned Key Type Mapped into the Image Note None Defined 6-8

6.5.5.2 Visit Status TABLE 6.5-6 VISIT STATUS MODULE ATTRIBUTES Attribute Name Tag Expected Matching Key Type Expected Returned Key Type Mapped into the Image Current Patient Location (0038,0300) O 2 No Note 6.5.5.3 Visit Relationship TABLE 6.5-7 VISIT RELATIONSHIP MODULE ATTRIBUTES Attribute Name Tag Expected Matching Key Type Expected Returned Key Type Mapped into the Image Note None Defined 6.5.5.4 Visit Admission TABLE 6.5-8 VISIT ADMISSION MODULE ATTRIBUTES Attribute Name Tag Expected Matching Key Type Expected Returned Key Type Mapped into the Image Admitting Diagnosis Description O 3 Yes Note 6.5.6 Patient Entity 6.5.6.1 Patient Relationship TABLE 6.5-9 PATIENT RELATIONSHIP MODULE ATTRIBUTES Attribute Name Tag Expected Matching Key Type Expected Returned Key Type Mapped into the Image Note None Defined 6-9

6.5.6.2 Patient Identification TABLE 6.5-10 PATIENT IDENTIFICATION MODULE ATTRIBUTES Attribute Name Tag Expected Matching Key Type Expected Returned Key Type Mapped into the Image Patient s Name (0010,0010) R 1 Yes Matching Supported. Universal, Single Value or Wildcard. User can query using full definition of VR_PN. Patient ID (0010,0020) R 1 Yes Matching Supported. Single Value matching. Other Patient Ids (0010,1000) O 3 Yes Other Patient Names (0010,1001) O 3 Yes Note 6.5.6.3 Patient Demographic TABLE 6.5-11 PATIENT DEMOGRAPHIC MODULE ATTRIBUTES Attribute Name Tag Expected Matching Key Type Expected Returned Key Type Mapped into the Image Patients Birth Date (0010,0030) O 2 Yes Patient s Sex (0010,0040) O 2 Yes Patient s Weight (0010,1030) O 2 Yes Patient s Size (0010,1020) O 3 Yes Patient s Age (0010,1010) O 3 Yes Occupation (0010,2180) O 3 Yes Ethnic Group (0010,2160) O 3 Yes Patient Comments (0010,4000) O 3 Yes Note 6-10

6.5.6.4 Patient Medical TABLE 6.5-12 PATIENT MEDICAL MODULE ATTRIBUTES Attribute Name Tag Expected Matching Key Type Expected Returned Key Type Mapped into the Image Patient State (0038,0500) O 2 No Pregnancy Status (0010,21C0) O 2 No Medical Alerts (0010,2000) O 2 No Contrast Allergies (0010,2110) O 2 No Special Needs (0038,0050) O 2 No Additional Patient History (0010,21B0) O 3 Yes Note 6.6 PRIVATE DATA DICTIONARY The Type of a Private Attribute is determined by the level of the Information Model in which it is used, and hence is not listed in this dictionary. Any Private Attribute contained within the Information Model is described in the preceding sections in the appropriate level. NO PRIVATE ATTRIBUTES ARE DEFINED. 6-11